Health secretary Alan Milburn has told a group of health authorities in south east England to send 500 patients abroad for treatment by the end of the financial year, although no arrangements are in place nationally or locally, it was revealed this week.
The announcement that Isle of Wight, Portsmouth and South East Hampshire HA, East Kent HA, West Sussex HA and East Surrey HA are to be 'test-beds' for sending groups of patients to other EU countries, follows a European Court of Justice ruling on overseas treatment in July.
The ruling led to Mr Milburn announcing that HAs and primary care trusts had the freedom to commission services for patients throughout the EU.
But although the HAs have been asked to start sending patients abroad by Christmas, issues such as entitlement to transport and insurance have not been resolved.
At local level contractual negotiations have not begun and the HAs have indicated that it is extremely unlikely that significant numbers of patients will be involved.
The work of the four HAs is being co-ordinated by Channel primary care group chief executive Peter Huntley. He told HSJ: 'One of the important things is we do not take money from cashstrapped hospitals. We will require some guidance, as elderly people are entitled to free transport, and there are considerable issues around clinical negligence and general medical insurance.'
He added: 'Only one in eight or nine may wish to travel abroad.'
Channel PCG business and finance manager Gail Arnold, who is co-ordinating East Kent HA's work, said: 'None of us are very far down the line.We haven't sorted out if it is patient-driven or whether we approach the hospitals on the continent and ask what could you do for us?'
The HA is planning to invite media on a trip to look at hospitals in Lille in France within the next couple of weeks, in an attempt to show local people that treatment abroad should be considered.
A British Medical Association spokesperson said: 'We would be in favour if it results in faster treatment of patients and as a short-term measure as we build up capacity. The downsides are the potential havoc it could wreak in trust and PCT budgets. If it is additional activity and it is in the interests of patients, it needs to be from earmarked funds.'
NHS Confederation chief executive Stephen Thornton said: 'This is always going to be a side issue. For people in Barnsley I would think it is going to be completely irrelevant.'