The Government's massive investment in the NHS has not delivered all the improvements it had been hoped, a former health minister has admitted.
Lord Warner, who retired in December, said expected benefits from expanding the workforce had been restricted by "productivity" issues.
The peer also hit out at staff for refusing to accept the need for change, amid growing dissent over the way reforms are being pushed through.
"If you say 'have (staff) delivered all that you would have liked them to deliver for that extra investment' then the frank answer for me is 'not as much as I would like to have seen'," he told Parliamentary Monitor magazine.
"They have done a lot of good things, but some of the productivity issues which have been around in the NHS for such a long time, need more work."
Developing training and administrative systems was an issue, along with an unwillingness to "embrace" the Government's £12bn IT upgrade for the NHS, according to Lord Warner.
"The idea that we could carry on with a paper-based NHS forever is nonsense, but a lot of the staff have been very slow to embrace the idea that you could have an electronic patient record and that you could move information about people faster," he said.
"You do many of your private transactions outside health and you expect to ring up, make an appointment, make sure it's correct, turn up on time and then expect someone to see you at the time.
"Now that doesn't always still happen in the NHS."
