A scheme to reduce NHS waiting lists by sending patients abroad will begin next week when 10 people from southern England will travel by Eurostar for free treatment in Lille, northern France.
The 10 went through final health checks yesterday at the William Harvey hospital in Ashford, Kent, to establish that they were fit enough to make the journey for cataract operations or joint replacement surgery at La Louvière hospital in Lille.
They will be followed by hundreds more over the next few months as the NHS struggles to reduce the number of patients waiting more than a year for routine operations.
Peter Huntley, chief executive of the Channel primary care group, in Kent, that is coordinating the experiment, said negotiations were almost complete on contracts with La Louvière and hospitals in Paris and north-west Germany.
"We are on the point of agreeing care packages with European hospitals that include travel, surgery and postoperative care [to] ensure each patient's stay is as comfortable as possible.
"We will make sure that everything is explained to patients in English, that English newspapers and cable TV are made available and, of course, that patients can get a decent cup of English tea," he said.
The decision to use foreign hospitals to tackle the waiting list in England was made by Alan Milburn, the health secretary, in October under pressure from a European court judgment in July. The judges said patients had a right to be referred elsewhere in the EU if they could not get treatment without "undue delay" in their home country.
In the long term, ministers hope to build up the capacity of the NHS to avoid the need to transfer patients to the private sector or hospitals abroad. But they admit it will take years to recruit the extra doctors and nurses needed to provide prompt treatment for everyone in pain.
In the meantime, use of hospitals with spare capacity in northern Europe might help the NHS to drive down the price paid for using private hospitals in England.
The test areas for sending patients abroad are east Kent, West Sussex, Portsmouth and the Isle of Wight.
Mr Huntley said patients needing hip or knee replacements would stay at La Louvière for between five and seven days. This would be longer than the typical stay in a British hospital because the French doctors wanted to provide intensive rehabilitation to make sure there would be no need for additional treatment.
In the unlikely event that further intervention was necessary, the patient would see the French doctors when they returned to the UK to assess a fresh batch of patients. The NHS would continue to provide emergency cover.
Patients' travelling expenses will be covered by the NHS and arrangements will be made if they want relatives to accompany them, but at their own expense. Cataract patients are likely to travel on the day before treatment, but undergo day surgery - as in Britain - without the need for longer hospitalisation.
Phillippe Boucquilon, a consultant at La Louvière and member of its board, said: "We're pleased to be involved in this initiative that will help British patients get the treatment they need as safely as possible. There is no reason why international borders should stand in the way of patients enjoying top quality health care."
Mr Huntley would not disclose the cost of using the French hospital, but said it compared favourably with the private sector in England. The Department of Health was funding the management costs of the experiment but not paying extra for the operations. Local hospitals would not lose out, however. "We are not removing anything from the current hospital providers, but we are adding capacity to reduce the waiting list," he said.
"Nobody will be forced to accept treatment abroad. Some people will be pleased to get the opportunity of early treatment abroad, others may be less keen. The important thing is that this initiative will add to the options available and will reduce waiting times for everyone," he said.
The government is gradually transforming the health service and tackling problems that have beset it for years, the specialist group set up to advise ministers on NHS reform reported yesterday.
But the doctors and nurses, managers and patient representatives who make up the NHS modernisation board said the biggest challenges were yet to come. They stressed that money alone would not solve everything.
Publishing its first annual report, the board said: "To meet the vision outlined in the NHS Plan, we will all have to embrace change on a massive scale. This means no less than a fundamental shift in our working practices and attitudes, some of which have remained unchanged since 1948."
'I have every faith in the hospital in France'
Barbara Sturgess was told in January last year that she would need an operation to replace her right knee.
Mrs Sturgess, 63, knew what that would involve. She had a joint replacement in her left knee three years ago and was happy with the result.
But she was less happy with the delay before surgery. A year ago she was told to expect an operation in 12 months, but as she waited in pain at her home on the outskirts of Dover, that became 15 months.
"I'm delighted to be going to France for treatment," she said yesterday. "I'm looking forward to the operation and getting rid of the pain. I've made inquiries about the hospital in Lille. In a recent survey it came top in France. So I have every faith in the hospital."
Mrs Sturgess was asked if she would feel nervous about going unaccompanied for an operation abroad. "I'm a big girl now and I can travel by myself. I go on holidays on my own and my family will visit me in Lille while I'm in the hospital."
She denied that sending patients abroad was an indictment of the capacity of the NHS to treat them within a reasonable time. "I could have had my operation here, if I'd waited a bit longer, but I have chosen this," she said.
John McCaul, 64, saw an advertisement last year in his local paper in Portsmouth about treatment overseas. "It was the best Christmas present I could have. If I'd been told I could have my operation quickly at the local hospital, I would have. But I've been waiting in pain for one year and one month and this choice came up out of the blue."
