It's a solid rule of thumb that whenever Frank Dobson offers an opinion, one should swiftly jump to the opposite conclusion. So if you are in any doubt as to the merits of the European Commission's plan to rationalise the current hodge-podge of arrangements for patients being treated outside their own country, consider this: Mr Dobson thinks it is a terrible idea.

As if that wasn't proof enough for you of the plan's virtues, the former Health Secretary has been joined by more than 50 of the most backward- looking of his fellow Labour MPs in signing an early day motion opposing it. It's clearly an idea of the utmost sagacity.

Markos Kyprianou, the EU Health Commissioner, was supposed to present his proposals to the European Parliament yesterday. Last-minute problems with the details mean that they will not be unveiled until next month. But, technicalities aside, we already know what is involved: patients from the EU will be able to choose in which country in Europe they wish to be treated and can then claim back the cost from their own healthcare provider. In Britain, of course, that will be the NHS.

The roots of the plan lie not in politics or even the European Commission's urge to interfere, but — as is so often the case in the EU — with judgments made by the European Court of Justice. In 1998 the ECJ ruled in cases brought by a Mr Kohll and a Mr Decker, who wanted to be reimbursed for, respectively, orthodontic treatment and the purchase of a pair of glasses, both from providers outside their native Luxembourg, and argued that their Government had been wrong, under the single market's free movement of goods and services, to deny them their money. That finding was reinforced and expanded in 2001 in the Smits-Peerbooms case, when the ECJ held that all medical care falls within the scope of free movement of goods and services.

It is these judgments — the law, in other words — that lie behind the current proposals. None of this should therefore come as a surprise. It certainly won't to Alan Milburn, who was Health Secretary at the time of the Smits-Peerbooms judgment. Mr Milburn had previously resisted all calls to allow NHS patients to be treated abroad, even when there was a waiting list on the NHS. Realising the implications of the ruling, he demonstrated his dexterity by announcing almost immediately the creation of NHS Abroad and gaining political credit for an innovative move. In reality, he saw that his hand had been forced by the ECJ and stepped in before being seen to be presented with a fait accompli.

The main controversy over the ECJ's judgments is whether they apply only to cases where patients have been denied treatment in their own country or more generally — if they simply choose to be treated abroad. Some argue that the rulings only apply where there is a denial of treatment at home. But the Smits-Peerbooms ruling made clear — as have others afterwards — that, as a general principle, all care is covered, and makes no reference to waiting lists or denial of care. And, in any case, what is “denial”? Is being offered treatment in a system where MRSA is rampant an acceptable proposition?

So in 2002, the Commission set up a consultation process to prevent an ever-growing number of ad hoc rulings and to work towards a consistent arrangement. The current plans stem directly from this.

Many bilateral agreements allowing patients to choose to be treated abroad are already in place, such as the “euregios”, which the German health insurance bodies set up with Dutch providers and which now includes Belgium. Some French areas co-operate with regions on their Belgian, German, Italian and Spanish borders. There are numerous other examples. Ministers are, apparently, worried that if the plans are pushed through, NHS patients will up sticks and opt for treatment in foreign hospitals that are not infested with MRSA or that offer better, faster and more successful treatments. So the word is that they will resist the plans.

And that pretty much says all we need to know about the mindset of our healthcare masters. They will resist giving patients a choice because they might exercise it. Here's what Mr Dobson had to say: “It will be catastrophic for the NHS if this directive goes through. The Commission either has no idea what damage this will cause to our NHS, or they simply don't care.”

Why will it be catastrophic if the NHS is capable of providing what patients need? Why on earth would anyone with a cataract in Humberside or a faulty hip in Cumbria choose to be treated in Madrid, Budapest or anywhere else in the EU if their local hospital gave them what they needed? No sane person would make that choice. If the NHS was in a position to offer the same level of care as that offered abroad, the impact of any such plan would be minimal. That's why it'll be “catastrophic for the NHS”. Having spent hundreds of billions of pounds attempting to prove that money would end the NHS's problems, it hasn't. So if patients are offered a choice of something better, they'll grab it.

Ministers can resist offering NHS patients a way out all they like, but since the root of the plan is European law, their resistance will be futile. The question is not if a system for cross-border treatment will be set up; it is how it will operate.

The concern of those who oppose the plan is not that patients will be worse off, that they will suffer poor treatment or that they are better off medically remaining within the NHS. It is ideological — that, because many will have good reason to opt for foreign treatment, they will take up that option and expose the anachronism that is the NHS.

Stephen Pollard is president of the Centre for the New Europe, Brussels

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