There will be no question of sending patients abroad against their wishes

Alan Milburn Health Secretary

"The government has been prevaricating over this for the last few weeks... Milburn says this new approach will not happen quickly because we require legislation, time to put it in place and so on.

"Let's face it, as we know there are thousands and thousands of patients in this country, people who need orthopaedic treatment like hip and knee operations, who are in daily pain every day."

The Conservatives said the system would lead to those who were more able to argue for the treatment being sent abroad, instead of those who needed the treatment more urgently.

Tory health spokesman Philip Hammond said: "Alan Milburn is simply allowing health authorities to send patients abroad if they so wish - and in the process is almost certainly distorting clinical priorities even further."

A British Medical Association spokesman said: "In the long term, the solution must be to improve services in this country."

Last resort

Mr Milburn said it would take several months for the changes to be put in place, and may require a change in UK law.

Alan Milburn: Changes will not happen immediately

He said the "overwhelming majority" of patients would continue to be treated in the UK.

He insisted that the government's priority was still to cut waiting lists by investing in the NHS.

And he stressed that health authorities and primary care trusts would have to meet the costs out of their budgets, and should use the measure only in the last resort.

"Clearly that can only happen where that is what the patient wants, and after a full clinical assessment shows that it meets their needs.

"There will be no question of sending patients abroad against their wishes."

European ruling

Mr Milburn's statement follows a ruling by the European Court of Justice (ECJ) that patients facing "undue delay" in their home countries could seek treatment in other EU states.

Previously, the law had permitted UK-based NHS patients to seek treatment abroad only in cases of tuberculosis or in otherwise exceptional circumstances.

The ruling led to growing demands from UK patients having to wait months and even years for surgery, to be allowed to go abroad.

Mr Milburn said that after receiving legal advice, that seemed a "perfectly sensible thing to do."

Seven-week target

A spokesperson for the National Assembly of Wales said the assembly would also consider sending patients abroad.

"As a rule, we feel it is in patient's best interests to get treatment close to home," she added.

A spokeswoman for the Scottish Executive said they would study the plan carefully.

But she added that the NHS in Scotland did not face the same pressures and had the shortest waiting lists in the UK.

The government has faced mounting criticism over waiting lists and delays to treatment, despite making the health service a priority in the 2001 election.

It aims that by 2005, NHS patients will have an average wait of seven weeks for an operation in UK hospitals.