Should the NHS drop the 'N'?
There will be some who regard the fact that NHS patients in England are now the only ones in the UK who might have to pay for prescriptions as evidence of unfairness. 90% of items are issued free even south of the border, but those who are eligible contribute £450m a year to the pot - equivalent, the Department of Health says, to the salaries of 18,000 nurses.
It is a question of priorities, ministers argue. Variation is an inevitable consequence of devolution and localism. These days, the national in National Health Service is about an over-arching philosophy not, as the government might put it, one-size-fits-all policy.
Success, they contend, should be about value in terms of outcomes, and analysis of the differences between England and Scotland on this score is revealing.
While per patient spending in England is roughly £200 less a year than Scotland, on almost any measure, the English NHS performs as well or better: on waiting times, productivity, patient satisfaction and mortality rate (Nuffield Trust NHS efficiency report [429KB PDF]).
Even when one takes into account deprivation and geography, experts insist the NHS north of the border appears less effective for more money.
This difference has even been given a name: "the Scottish effect". Scotland's taxpayers might wonder whether that is fair.