Will the NHS in Scotland really be better off, as Alex Salmond has promised, if Scotland votes for independence on 18 September? Civil servants seem to think it will face a huge funding gap.
It was reported today that the government has outlined a radical cost-cutting plan for NHS Scotland, presented to a meeting of health board chief executives and civil servants last month.
The outline, seen by the BBC, suggests Scotland's NHS faces a funding gap of £400-£450m during the coming financial year, and that sweeping changes would be needed in the event of independence.
"The status quo and preservation of existing models of care are no longer an option given the pressing challenges we face," the papers say.
The Scottish government has emphasised its dedication to protecting and increasing the NHS budget, with an initiative in place to transform care by 2020. But the papers say there are continued commitments which increase the cost of expensive hospital care and are “directly in conflict” with the vision.
It says the "status quo in terms of service and workforce planning is not an option", and that reforms such as the centralisation of hospitals and closure of service will have to be considered. The SNP vowed to end the closure of services when it was elected in 2007.
The papers state that "radical and urgent decisions need to be made regarding the shape and configuration of services," but point out that the NHS boards do not have the authority to implement the changes needed.
"The current pattern of services is underpinned, but short-term money and fixes won't stack up going into next year,” said the whistleblower who shared the papers with the BBC.
"Services are unsustainable right across Scotland, from three emergency centres in Lanarkshire to emergency care at the Vale (of Leven) to paediatrics at St John's (in Livingston), and with particular issues for more rural boards, hence the problems at Grampian.”