PATIENTS will be encouraged to bypass their local NHS hospitals to be treated at elite foundation trusts and private treatment centres anywhere in England under reforms to be introduced by Patricia Hewitt, the health secretary, this week.

In an acceleration of the government’s drive to create more competition between hospitals, patients who are dissatisfied with the standard of care offered by NHS hospitals in their area will be given the option of travelling to a top-rated foundation trust anywhere in the country.

The changes are likely to anger old Labour MPs and health unions who fear NHS hospitals with poor ratings will go into further decline or shut.

Patients will, in time, also be able to choose which surgeon carries out their operation, according to Hewitt.

At the moment patients who need a routine operation are given the choice of treatment at four or five hospitals in their area, one of which is a private hospital or independent sector treatment centre. From this week England’s 32 foundation hospital trusts and 21 treatment centres will be added to the list patients can choose from.

In an interview with The Sunday Times last week, Hewitt said a backbench Labour MP, opposed to competition in the NHS, had admitted to her that their local hospital was substandard and that patients had gone elsewhere.

“The MP said, ‘Quite honestly, everybody knows that our local hospital is not very good.’ So when choice was offered these constituents just bypassed the local hospital and went somewhere else,” Hewitt said.

“Patients in a working-class constituency were very capable of judging that their own local hospital did not have a good reputation.”

Hewitt admitted that the increased competition could result in some local NHS services closing.

“We will support the hospital to make the improvement but if this is not achieved and there are better alternatives nearby it may well make sense for that hospital to say, ‘We are not very good at this particular treatment: we are going to concentrate on the things we are good at.’ Other hospitals or treatment centres nearby can expand to look after the patients,” she said.

To become a foundation trust a hospital must achieve the maximum three-star rating, which is measured on standards of care including waiting times, rates of MRSA (methicillin- resistant staphylococcus aureus), cleanliness and financial management.

Foundation hospitals are part of the NHS but they are self-governing, free from the control of central government. They are free to raise their own funds. Regular NHS hospitals outside a patient’s local area will not be on the “menu” people can choose from.

Patients on benefits or job seekers’ allowance would have their travel paid for but others would have to cover such costs.

Hewitt believes traditional NHS hospitals would be unable to cope with the extra patients. The government hopes the prospect of attracting extra patients will be an incentive for hospitals to reach the standards needed to become foundation trusts.

Patients will also eventually be able to choose their surgeon. Over the next two years the government plans to make public details of all surgeons’ performances, including how many operations need to be redone and how many patients die during or shortly after surgery.

This weekend James Johnson, chairman of the British Medical Association, predicted few patients would choose to travel to hospitals outside their area. “The majority of cases will want to go to their local hospital,” he said. “Who would want to go 200 miles away unless it was for very specialist treatment?”

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