The NHS Bill cleared the Commons last night with only several Lib Dems deciding to vote against the Government’s proposals, despite lingering fears that there is simply too much private involvement and profiteering in the suposedly public NHS.

I have not had a chance to see the exact vote breakdown but it seems likely that some Scottish Lib Dems MP will have voted for the proposal and some Scottish Labour MPs will have voted against, despite health being devolved to Holyrood.

This is, therefore, the latest example of the West Lothian Question, where Scottish MPs (and by extension Scottish citizens) can have a say on English affairs but English MPs and citizens have no say on Scottish affairs. It is, and has been for quite a while, an unsustainable and deeply unfair arrangement.

So, in one respect it is to be welcomed that the UK Government has set up a Commission of ‘independent, non-partisan experts’ to look into and hopefully answer once and for all the West Lothian Question.

Supporters of the SNP will suggest that the solution is only a few years away and comes in the shape of a Yes vote to independence. This would of course put the issue to bed but the UK Government has a responsibility to assume that the United Kingdom as it stands is for the long term and needs to find a lasting solution accordingly.

For me, there is only one answer – four devolved Parliaments for the four constituent nations.

The imbalance in Scotland (and Wales and Northern Ireland) cannot continue. It’s not just votes in Westminster where problems arise, but a Parliament that spends money that it doesn’t raise is ultimately unworkable.

The only party that should fear a federal UK is the SNP. The balance and equity that such an arrangement provides will allow Scotland to crack on with free education for students, free care for the elderly, a renewables push and different levels of taxation to pay for it all, whether it’s Income Tax going up or Corporation Tax going down. There will be little disagreement that Nationalists can leverage to their own ends.

David Cameron going on the front foot on this issue, with rare support from Ed Miliband and Nick Clegg, would finally put Alex Salmond on the backfoot and marginalise calls for independence, not that that should be the reason for advocating federalism, that’s just the politics of it.

A scaleable model for any part of the UK from council through nation through country up to the EU is a flexible solution that fairly and democratically meets the needs of every UK citizen, whether your issue is local, national or international.

It won’t be easy for a Prime Minister to relinquish so much power and many believe that it will be impossible, but for me there are only three choices that the UK has:

1 – Independence
2 – Scrap the Scottish Parliament and Welsh Assembly
3 – Federalism

I simply cannot envisage another and we’re certainly not doing ourselves any favours by having Scottish MPs voting on non-Scottish issues to support a Prime Minister that we roundly rejected.

Tam Dalyell’s West Lothian Question has riddled us long enough. Let’s find a way to move on.