The international health service: plan to give British patients the right to treatment abroad

Britons stand to gain new rights to seek health treatment abroad and then bill the National Health Service, under "health tourism" plans unveiled by the European Commission.

The moves could lead to a big expansion of cross-border choice for patients but could also increase the bill for the NHS if it is forced to reimburse more treatment administered abroad.

The European commissioner for health, Markos Kyprianou, said he also plans to consult on the possibility of allowing surgeons to perform operations abroad and permitting doctors to offer advice and treatment via the internet.

The initiative follows a series of judgements in the European Court of Justice which established the right of European citizens to seek treatment abroad if they are entitled to it in their own country but have suffered an unreasonable delay.

In May, the court backed a British woman, Yvonne Watts, who went to France for a hip operation because she faced a year-long wait for an NHS procedure. Judges ruled that patients facing "undue delays" in waits for operations should be entitled to treatment in other EU countries.

Mr Kyprianou said: "A clear, practical framework is needed to enable patients, and those who pay for, provide and regulate health services, to take advantage of cross-border health care where that is the best solution. This will also help to unlock huge potential for European co-operation, while respecting national responsibility for their organisation and financing."

The proposals, which are expected to go to EU ministers next year, will be based on the European Court ruling but as yet there are no details on how to define the "undue delays" that prompt the right to cross-border treatment. The commissioner made it clear, however, that the right to receive treatment abroad would apply only if a patient was entitled to the procedure in their home country.

The plans will need approval by EU health ministers who could agree a new set of rules by majority vote.

British officials say the NHS is now less likely to face a big bill because the Government has sought to cut waiting lists and has sometimes sent patients abroad.The Department of Health says that, while in 2000, people could be waiting as long as 18 months for surgery, the average wait for inpatient treatment was now eight weeks. It has also set a target to reduce to 18 weeks the time from an appointment with a general practitioner to an operation.

In July 2001, the Smits-Peerbooms judgment in the European Court decided that health care must be subjected to the same EU laws as other services, even when funding came directly from the public purse.

Peter Elphinstone, 55: 'The treatment was nothing like you'd get in Britain'

To undergo hip replacement surgery, Peter Elphinstone, a dentist from Maldon, Essex, travelled to Abbeville in France.

"I injured myself 30 years ago when I was a student and in the last few years it had started to play up," he said. "I went for an X-ray on the NHS in May but I don't think it was very well done; I don't think they really got to see exactly what was going on. The doctor recommended that I should leave off having a surgery for a bit, but then it began to get really bad.

"I didn't want to have to go on a waiting list and sit there in pain for weeks. I had read about the People Logistics company and phoned them to ask about surgery abroad."

After examining Mr Elphinstone, the surgeon recommended a different type of surgery from the one the NHS doctor had suggested. He underwent a total hip replacement in Abbeville and his wife stayed near the hospital while he recuperated.

He said: "The surgeon was brilliant and talked everything through with me, and the nursing staff were absolutely fantastic. The surgeon came round to see everyone each night and even though I don't speak French, there were no problems. I stayed in the hospital for two weeks and I'm now back at work and walking.

"I feel bad because it sounds like I'm doing down the NHS, but the treatment I got was like nothing you would get in a hospital in Britain, even most private ones. I'm not saying the NHS is terrible, it's just there are places where you can get better treatment. I'm all in favour of opening up the healthcare systems if it means we can get access to treatment like that."

Maxine Frith