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Leading article: The NHS can be improved

The Health Service is not the only way to deliver healthcare free at the point of access. It is simply the method used in Britain today.

So when politicians pledge their support for it, as they have done in recent days, they are really expressing their faith in a mechanism of bureaucracy. As the volume of letters received by this newspaper demonstrates, this faith seems woefully out of step with the mood of the electorate, who rightly observe that no area of Britain's bureaucracy should be a shibboleth in such hard-pressed times. If any public service is to improve there must be innovation, diversity and intelligent analysis. Not even the NHS is sacrosanct.

Instead, the NHS has been a football booted round the pitch of British politics with the objective that either the Labour or Conservative parties will score against the other. Witness the Prime Minister's absurd "twittering" of support last Wednesday, and his subsequent challenge to David Cameron to prove that his party was a similarly worthy custodian of the service. Though many in the Tory party would welcome serious debate on this issue, it was a gauntlet Mr Cameron speedily picked up, declaring his undying faith in the NHS and stopping just short of sacking those in his party who had criticised it.

Far from discussing the fundamentals, the two main parties have engaged in school-yard trumpery on the theme of "who loves the NHS more". But declarations of love are no substitute for policy debate. This is a flippant approach to a vital subject. Worse, it obscures meaningful questions: about how much we pay the NHS and how efficiently it spends that money; about the service it delivers; about whether we should learn lessons from aborad; and about Tory proposals to replace targets with "choice" mechanisms that could take a chaotic decade to bed-in.

Yesterday, in these pages, Ian Birrell set out six sensible proposals, designed to promote the start of debate on future reform to create a more efficient and effective service. The aim is to put patients' needs before bureaucratic targets, encourage transparency and promote innovation. Serious discussion of this kind is needed more than ever, but to engage in it our leaders must do more than inanely twitter.