Published: 04/04/2002, Volume II2, No. 5799 Page 6 7

The government is planning a massive expansion of treatment abroad, with anyone waiting more than six months for orthopaedic and general surgery in London and the south of England to be offered overseas treatment from April next year, HSJ has learned.

The decision to expand the scheme, which could eventually see tens of thousands of patients going to Europe for treatment, follows the completion of the overseas treatment pilots for patients with cataract and hip replacements in south east England.

As well as sending patients abroad next year, the government is also planning to have foreign medical teams working at a number of sites across the country at the same time, to drive down waiting lists. It is likely they would work on day-case surgery and would rotate working between the UK and their own country.

Though the overseas treatment pilot sites - Isle of Wight, Portsmouth and South East Hampshire health authority, East Kent health authority, West Sussex health authority and East Surrey health authority - formally finished this week, it is likely that additional patients will continue to be treated in France and Germany for the next couple of months.

Around 200 patients have been sent abroad so far, and though the final total may be about 300, it falls short of the 500 the HAs were asked to send abroad by health secretary Alan Milburn, last autumn.

The results of the pilots are now being evaluated by York University's health economics consortium, but HSJ sources have made clear the government has already decided to offer the option to go abroad far more widely.

A Department of Health spokesperson said: 'In due course, we envisage launching a procurement exercise to identify suitable overseas providers for longerterm contracts, drawing on the experience of the pilot. It will take a number of months to put this in place.

'Though any primary care trust or acute trust may purchase care overseas, it is planned to establish a lead commissioning arrangement whereby a small number of NHS bodies purchase overseas treatment on behalf of the whole NHS.'

Work on bringing foreign teams to operate in the UK is due to be discussed at a meeting organised by the DoH in Bruges on 12 April, to follow up an earlier meeting in London in February.

The meetings bring together potential foreign providers and interested trusts to talk through the issues involved in contractual arrangements.

The DoH spokesperson said trusts were currently being encouraged to work on pilot projects to bring teams in from abroad.

lNHS chief executive Nigel Crisp's office has told the Christian Barnard unit at the Groote Schuur Hospital in Cape Town, South Africa, that it is unlikely to win a bid to treat British heart patients.

Last month, two Midlands public health doctors revealed that they had been in talks with the hospital to take UK coronary artery by-pass patients. The hospital is half empty because many South Africans cannot afford healthcare.

But the DoH has told the hospital that it is 'likely to err on the side of caution on this issue', and said that its preference would be to opt for relatively short flights to Europe rather than long-haul flights to Africa or the US.

It also pointed out that the former South African president, Nelson Mandela, secured an agreement with the British government that the UK should not consider recruitment of doctors from South Africa unless through an agreed South African government development programme.