The EU has begun consultations with its member states on a pan-European directive that could allow citizens of any country to travel for operations or other medical procedures to any other country in the community, with the medical costs reimbursed by their own governments.

The EU has begun consultations with its member states on a pan-European directive that could allow citizens of any country to travel for operations or other medical procedures to any other country in the community, with the medical costs reimbursed by their own governments. The catch is, they would have to pay their own travel and accommodation bills, and even shell out the cash for the procedure in the foreign hospital of choice, before any money could be reclaimed.

Critics fear this could trigger a wave of health tourism, damaging to national health services, or even lead to certain countries specialising in specific treatments, to the detriment of a more general spread of medical expertise. But those who have examined the scenario in terms of financial reality say there is no need for panic or xenophobia. Existing EU law already allows travel for health care and provides reimbursement to the level that the same procedure would cost in the country of origin. If the price is higher in Britain than in Germany, a German patient arriving here would have to meet the difference from his or her own pocket. The new directive, it would seem, is merely a formal codfication of those rights.

Nobody really gains or loses by any appreciable margin. Fewer than 50,000 Britons a year have operations abroad. Many of those are expatriates living permanently in Spain or France, or rich individuals who opt for private treatment anyway. The one major area where there might be leeway, and a decided financial advantage for British citizens, is in dentistry. With more and more UK dentists opting for private practice, finding an NHS practitioner, far less managing to join a register of NHS-funded patients, has become almost impossible. Enterprising tour companies already offer dental holidays to Poland and the Baltic states, where dentistry is just as advanced but is half the price.

The other group who stand to benefit are the expats who live half the year abroad and the other half in the UK. They could undergo procedures at the nearest hospital to their holiday home and reclaim the costs from the NHS, whereas permanent expats have to register with the health service of the country in which they have taken up residence and pay local medical insurance. However, the numbers involved are relatively insignificant. On balance, while Glasgow's Beatson boasts the best equipment in the cancer-treatment field, and Belgium's hospitals are virtually MRSA-free because of excellent screening regimes, the directive is unlikely to change anything except the depth of EU paperwork.