Patients will be able to demand NHS-funded treatment anywhere in the European Union without the prior approval of a doctor under wide-ranging proposals to guarantee health rights announced yesterday.

Under the EU scheme, patients would be able to beat NHS queues or avoid problems such as high superbug rates by shopping around for care abroad. They would then be eligible to recoup the NHS cost of the procedure.

The proposals for cross-border healthcare were compiled after a series of court cases brought by patients trying to get money back after treatment overseas, including those escaping NHS waiting lists.

The proposals were hailed in Brussels yesterday as a bonanza for patient choice, bringing state-of-the-art facilities around Europe within reach.

But the small print of the new directive will allow the Government to insist that patients must obtain permission from the NHS in advance for all hospital treatment and for many out-patient procedures, such as scans and minor surgery, officials said last night.

Traditionally the quality and speed of treatment for elective procedures - such as hip and knee replacements and cataract removals - in countries such as France, Germany and Belgium have made travelling abroad an attractive prospect. The NHS itself has, on occasions, relied on using such clinics for a few core patients in the past.

However, NHS waiting times have now shortened significantly. Where once many people were waiting at least a year for orthopaedic and ophthalmic treatments, there is now a maximum wait of six months, and many patients are treated within three. Health specialists believe that the attraction of treatment abroad might now rest on factors such as lower rates of MRSA and C. difficile.

Under the directive, patients who go to the Continent are likely to retain their full status as NHS patients - allowing them to keep their place in queues for physiotherapy and other recuperative care.

But the Department of Health said last night that it was confident that by the time the draft EU directive becomes law, the Government will have retained the right to say where patients can receive treatment.

A spokesman also insisted that the NHS would not suffer from an invasion of “health tourists” because the EU proposal states that if a particular service is being overloaded, the Government can apply for it to be omitted from the equal access scheme. “The Government is clear that ‘health tourism’ will not be funded by the NHS,” he said. “We are also absolutely committed to ensuring that, where UK patients choose to travel abroad for care, the NHS retains the ability to decide what care it will fund. Equally, anyone from other member states travelling to the UK specifically for healthcare will have to pay the full NHS cost of treatment up front.

“The priority for the vast majority of NHS patients is high-quality healthcare received close to their homes. We remain committed to providing this.”

With the most pressurised health systems tending to be in Eastern Europe, Britain is also thought to be a less likely option for foreigners in search of care because of distance. The draft EU directive published yesterday states that, so long as a treatment is already provided under the patient’s national heath system, he or she can opt to receive care in another EU country and be reimbursed “without prior authorisation”.

Patients would have to pay the medical costs up front, but would be assured of repayment up to the level of cost of the same or similar treatment under their own health system.

They would have to pay travel and accommodation costs themselves, as well as any premium if the overseas treatment is more expensive. The directive also confirms the existing guarantee that the full cost of treatment abroad will be refunded when an NHS professional has agreed that it is necessary for the patient to go overseas.

But British officials pointed to a loophole in the proposal which states that those wanting to go abroad for hospital treatment must obtain the prior approval of the NHS if the Government can show that an exodus of patients could seriously undermine its planning or capacity.

The draft directive must now be examined by the European Parliament and the Council of Ministers before becoming EU law. The European Commission said that it was not trying to harmonise healthcare across the EU, but to lay down a framework on patients’ rights to treatment abroad.

“Patients will be able to receive treatment in any member state, which will be reimbursed at home up to the level of the same or similar treatment in their health system,” Androula Vassiliou, the Health Commissioner, said.

She added: “Patients from any country will enjoy equal treatment with the nationals of the country in which they are being treated and cannot be discriminated against.”

This means that in countries with long waiting lists, patients from abroad will have to join the queue. She added: “It will allow excessive demand from one country to be met by excessive capacity in another country. This is the essence of the cooperation.”

More than 50 Labour MPs have signed a Commons motion protesting that only the wealthy will be able to make use of the EU proposals to seek out care abroad because the cost needs to be paid up front.

Jon Trickett, MP, said: “This directive would undermine the fundamental principles of the NHS, impose unnecessary burdens of cost and bureaucracy, overrule clinical priorities and worsen health inequalities. Treatment would no longer be free at the point of delivery and only the wealthy can use these new so-called rights.”

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