The NHS has been neglected by its political parents, an editorial in this week's Lancet says.
The medical journal links Gordon Brown's planned reforms of the NHS to its wider relationship with the Department of Health, which it accuses of narrow centralisation working against progress.
Mr Brown outlined plans to create a "more personal and preventative service" in a speech to healthcare professionals on Monday.
He announced diagnostic scans for all those at-risk of a number of diseases and pledged an NHS constitution which would enshrine both the "rights and responsibilities" of patients.
Today's Lancet editorial says the prime minister "lacks advisers with sufficient courage to tell him that a constitution is likely to be merely empty rhetoric".
It says separating prevention from treatment is a false dichotomy and says plans to strengthen the divide between GPs and specialists are "hopelessly anachronistic".
"A fundamental problem facing the NHS is that it is not joined up in its culture or planning," the editorial says.
"The NHS deserves a happy [60th] birthday on July 5th. But despite lavishing it with praise and presents, its political parents have been neglectful. A sharper scientific focus to the UK's health-systems reforms is needed."
Reviews of the NHS and medical training from Lord Darzi and John Tooke respectively are on the right track, the editorial says, but there are risks the government will hinder recommendations fostering better management of health.
"Whether they can survive the DoH's preference for centralised ideology over professionally led, devolved, and evaluated innovation is another matter," it concludes.