Health service managers have expressed caution over moves to allow patients to receive treatment paid for by the NHS in other European countries.

The government has performed an apparent U-turn after sustained pressure from patients' groups and sections of the media, in the wake of a high profile European Court of Justice ruling that patients facing 'undue' delay should be able to receive treatment in EU countries, funded by their own country's healthcare system.

Health secretary Alan Milburn said he would receive legal advice on the judgement in the next few weeks. 'In the meantime, it is my intention to make clear to health authorities and primary care trusts that they are able to commission services from other European countries as part of their wider efforts to reduce waiting times for NHS treatments.'

He warned: 'This will not happen overnight. For one thing, it may require legislation. It will also take time to put in place robust systems to guarantee patients high standards of care and taxpayers value for money.'

His statement appeared to contradict previous indications from the Department of Health that the ruling would not affect current practice. This week, the DoH denied any shift in policy and claimed it had merely been considering the judgement.

John Yates, waiting-list expert at Birmingham University's health services management centre, said concerns about follow-up care had limited transfers of patients around the UK in the past. 'This is not the first time We have hit this issue of bussing people about.We haven't had a huge take-up and the medics have been very worried about it - rightly so.'

He suggested that the 'threat' of contracts going to Europe 'could be just a means of provoking the NHS into pulling its finger out'.

A spokeswoman for East Kent health authority, across the water from mainland Europe, and with good transport links, reacted cautiously to Mr Milburn's announcement. 'On the face of it, it looks as though this would help, if you are able to send someone to Calais.'

But she queried whether the procedures available would match long waiters' individual needs.

She added: 'All we will be able to pay for is the inpatient care. The NHS would not be able to pay for accommodation or accommodation for family members or transport. It could be very expensive and therefore not viable.

'I am not sure all of this stuff has been properly thought through.'

NHS Confederation chief executive Stephen Thornton said sending patients to Europe 'in principle' was 'an excellent notion', given the backlog of people waiting for treatment.

But it was likely to be a 'relatively minor' activity. He compared it with buying a car on the Internet.

'There is been a lot of publicity. It is had an effect on providers in this country, maybe geed them up. But very few people have actually done it.'

He stressed that treatment overseas must be 'organised' through the commissioning process not by 'affluent middleclass' individuals.