Euro providers could claim place on choose and book

An EU source told HSJ the move could be one consequence of the European Commission's draft directive on patient mobility.

The directive goes beyond recent European court rulings, which have focused on patients facing delay. Patients will be able to choose to have their care anywhere in the EU simply because they prefer to.

NHS European Office director Elisabetta Zanon said she expected it to have the greatest impact in cases of rare diseases or conditions where the UK performs relatively badly, such as some cancers.

The Eurocare-3 study of cancer survival across the EU ranks the UK alongside Eastern European countries as having the lowest survival rates. "If there is some modern treatment available abroad but not here, patients will want to go," Ms Zanon said.

The directive could require primary care trusts to pay up to the equivalent NHS tariff for care abroad as long as the patient was prepared to pay any difference and travel expenses. PCTs would not have to pay for care not deemed cost effective by the National Institute for Health and Clinical Excellence.

The commission estimates that the directive will cost the NHS£40m a year.

But its estimates are based on the assumption that just one in 10 people on waiting lists or with an "un-met need" will activate their rights.

European Commission figures published alongside the directive suggest that the UK already exports more than three times as many patients to the EU than it imports. In 2005 the UK was charged ó163m (£130m) for NHS patients treated elsewhere in the EU.

The draft directive - which could take more than three years to implement - applies to any care given by what the EU defines as a "health professional". This includes eye and dental care.

A Department of Health spokesperson said: "The government is committed to ensuring that, where UK patients choose to travel abroad for care, the NHS retains the ability to decide what care it will fund."

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