A scheme which will offer long-waiting heart patients the option to choose where they get treated is launched in parts of England on Monday.

The government is struggling to cut waiting times for heart bypass surgery, and believes that the initiative could help.

Patients who have been waiting more than six months for surgery at an NHS hospital will be offered three choices.

They can either get treated at a private hospital, travel to another NHS hospital which has more capacity, or opt to stay and finish their wait at their local hospital.

Some patients may be sent abroad to hospitals in continental Europe.

Deals are being struck between the Department of Health and Spain to use surplus capacity there.

The scheme will be tested in pilot schemes in various parts of the country, but particularly in London and the south east of England, where waiting problems are the worst.

Mr Milburn said: "This is an important first step in giving patients more choice in the NHS.

"As we expand the NHS and recruit more doctors and nurses and other health professionals we can ensure faster treatment, higher standards of care and a better patient experience.

"Waiting times are falling for heart surgery and are falling across the NHS but some patients still wait too long and we will continue our efforts to reduce waiting times according to the NHS plan.

"Today marks an important point on that journey as patients are offered the choice of quicker treatment."

Patient adviser

Patients who meet the criteria will be contacted by a "patient adviser" to give them the chance to make a choice.

Travel expenses for both themselves and a relative will be paid - as will hotel expenses for the family member.

There have been fears that long distance travel is not beneficial either before or after major surgery - with particular concern about the risk of blood clots caused by sitting still for long periods during the journey.

However, government advisers insists that there have been no documented problems.

A patient leaflet about the scheme says: "Patients in the south west often travel to London for treatment, and recently, patients from Liverpool have travelled to Glasgow to receive faster treatment.

"The experience is that this has been done safely and that the travel has had no adverse effect on patient's health."

Private hospitals bidding to do the work have been tested against strict criteria, and must have access to proper facilities so that doctors can cope with every eventuality.

However, not all doctors and administrators favour the idea, fearing that it will divert scarce resources away from the NHS.