Yvonne Watts High Court challenge is a test case

Arthritis sufferer Yvonne Watts, 72, of Queen's Park, Bedford, says the taxpayer should cover the �3,800 cost of the operation.

If she is successful, the ruling could have major implications for the NHS, which may have to fund many similar cases.

Mrs Watts argues that under European law she is entitled to overseas treatment if there is "undue delay" in this country because of long waiting lists.

The grandmother-of-four, who is also claiming the future cost of urgently-needed surgery on her other hip, has accused Bedford Primary Care Trust and the government of unlawfully refusing to sanction the funding.

Mr Justice Munby heard Mrs Watts had been in severe and sometimes excruciating pain from rapidly-deteriorating osteoarthritis.

'Undue delay'

The waiting list for treatment was 12 months.

She shortened that time by paying for a private consultation and putting pressure on the hospital to move her up the list.

But Mrs Wayne was told she would still have to wait more than eight months.

When she applied for authorisation to go abroad for treatment under the NHS's E112 certificate scheme, the Trust told her it was not necessary because it was meeting the Government's target waiting time of 15 months for in-patient treatment.

Her counsel, Richard Gordon QC, argued that to decide the issue of "undue delay" by reference to the waiting list target was wrong.

The effect was to prevent Mrs Watts from receiving treatment at an early stage despite the urgent clinical need for it, he said.

'Priority for clinical needs'

Lawyers for the hospital trust told the judge it had offered to carry out Mrs Watts' hip replacement within three to four months, despite a general in-patient waiting list of 12 months.

Mrs Watts was offered a "slot" on 6 May this year, but she chose to travel to France, where she had a right hip replacement on 7 March.

Steven Kovats, counsel for the Trust, said the decision not to recommend funding for surgery abroad was based on the priority to be given to the patient's clinical needs.

Had Mrs Watts waited another two months, surgery in this country would have been equally effective, he said.

Judgment was being handed down at 1430 BST on Wednesday.