The Scottish independence debate has now pitched the former economist Alex Salmond against The Economist. Their front page illustration makes light of the portentous financial state that it argues would follow a break up of the union (Skintland, capital city - Edinborrow...) and neither the wit of the cover nor the argument inside has the first minister of Scotland smiling.

The Economist argues that when practical details of the costs hit home, support for independence is softer than current opinion polls might suggest. A practical detail hit home for me recently with more than a little irony as I found myself at the limits of Scotland's healthcare capability.

Some context. In November 2009 after almost a year of being passed between my GP, dentist and the ear, nose and throat clinic, what was previously suggested to me as a dental abscess was diagnosed as a cancerous tumour in my jaw. By that time it had also spread to the lymph nodes in my neck. 

After attempting to get the spread under control the emergence of another tumour on my neck in August last year brought me to a crossroads. It had not come on its own, as a scan revealed another growing in my armpit. A surgical intervention was deemed too complicated and risky, the clinical advice was... go home and prepare for the worst.

I decided it was too soon to throw in the towel and I looked to the other side of the Atlantic.

Having cashed in all my chips, I rolled up with my fighting fund at the Memorial Sloan Kettering in New York. They concluded they could help, but pointed out that with any kind of set back the impact on costs could bankrupt me. They did however recommend I try an establishment a little closer to home and pointed me in the direction of the Royal Marsden in Chelsea.

So I am now an NHS patient in London. By way of New York.

Last month I had the operation to remove the tumour from my neck - which thankfully was successful but I've lost six months since the procedure was declined in Scotland, and time is critical when fighting cancer. Next up is the tumour under my arm, we are still in the fight, fighting is hope, and hope is everything.  

When I complained to my oncologist in Edinburgh last year that my diagnosis had taken too long, she agreed but pointed out she couldn't blame any one person. In my profession we call that a systemic failure, and here is where the irony kicks in. The person at the head of this particular system, the minister with the health remit in Scotland (and Salmond's deputy) Nicola Sturgeon was a contemporary of mine at University where we occasionally crossed swords in the self-important chamber of student politics.

Back then as now I find the argument for independence unconvincing, but in returning to Scotland to set up a business after almost 10 years in London I should have been something of a poster child for the SNP - creating jobs and contributing to the economy.

To be clear I don't think for a minute that Salmond or Sturgeon or the hard working NHS teams I've encountered in Scotland are particularly at fault here. It's just that sometimes, no matter how progressive your policies are there are advantages to being part of a bigger system where rare and complicated cases like mine are quite simply more common. As for benefits to Scotland's size? Well one could reasonably argue pace, urgency and better join up between front-line and specialist services should follow. Alas not in my experience.

So the burning question then is, if Scotland becomes independent would I still be able to be referred to hospitals in England? I can't take any chances, and at the moment while I would prefer to stay put in Edinburgh, I'm looking to relocate to the vicinity of the hospital that is willing and able to treat me, in London. Otherwise the cost of independence could be too great for me.

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