Get your bypass operation on the IHS

By <strong>Alice O'Keeffee and Katharine Hibbert</strong>

Health tourism once meant convalescing from tuberculosis at an Alpine sanatorium, or taking the waters at a French spa. Today, the ill travel to take advantage of cheaper private healthcare, innovative treatments, or to bypass ethical regulations. This is where they go:

France: La Louviere, Lille, specialises in cataract operations, knee and hip replacements. It caters for the British market, providing "single rooms with . . . English-language newspapers and a la carte menu in English". Typical meal: coquilles St Jacques, filet mignon and Provencal tomatoes. Costs: cataract operations - £1,000 at la Louviere and £2,000 for private treatment in the UK; hip replacement - £4,000 in France or £7,600 UK private; knee replacement - £3,000 at la Louviere or £8,500 UK private.

British cancer patients have travelled to France and spent up to £60,000 on treatment with the new drug Taxotere, not yet available in the UK. Other cancer treatments, including the new chemotherapy drugs Platinol and Herceptin, as well as more modern forms of radiotherapy, are widely available in northern Europe but not in the UK.

Germany: Munich International Airport medical centre offers "medical tourism packages", including accommodation and sightseeing as well as diagnosis, inpatient or outpatient surgery. Patients fly in, have tests or treatments at the airport, and fly home, sometimes in a single day. Specialisms include hand surgery, plastic surgery, endocrine surgery and minimally invasive surgery. Any non-emergency surgery "can be done in Germany at very significant cost savings", claims the specialist website www.euro-surgery.com.

Greece: Interbalkan European Medical Centre in ThessalonIki boasts that "the Doric simplicity, the soothing sound of water flowing gently from fountains and cascades . . . create an environment of tranquillity and optimism in this Temple of Health". Our DoH is considering sending up to 25,000 patients there for hip replacements and hernia and cataract operations.

Italy Clinics offer fertility treatments that UK watchdogs outlaw on ethical grounds. British women in their late fifties have travelled to Italy for IVF treatment with donated eggs and sperm. Couples have also sought treatment in Italy to select the sex of their child.

Cuba: provides treatments for more than 4,000 foreigners each year; they include eye operations, cosmetic surgery and drug rehabilitation. The Camilo Cienfuegos Centre has pioneered treatment for retinitis pigmentosa, a degenerative eye disease that can lead to blindness but for which no help is available in Britain; the 21-day plan costs £4,835. El Quinque in HolguIn treated Diego Maradona for his cocaine addiction: its course costs £3,118 per month, about a quarter the price of comparable treatment at the Priory in London. Doctors in Cuba earn less than $20 per month, whether treating foreigners or locals.

South Africa: Roughly five Britons each week arrive for medical care ranging from major heart and cancer operations to cosmetic surgery. Groote Schuur Hospital, where the world's first heart transplant was performed in 1967, has appointed a manager specifically to handle inquiries from the UK. "We would be able to assist the UK with addressing your waiting lists at a lower cost than you can provide," says the hospital's chief executive.

Egypt: John Guy, a 68-year old from Manchester, recently flew to Cairo for a hip replacement. It cost £3,000 less than he would have paid to have the operation done privately in the UK.

US: Cancer specialists offer innovative treatments not yet available in the UK. Prostate cancer patients, for example, have travelled there for prostate brachytherapy, which involves implanting radioactive "seeds" into the prostate. They may also travel to get the new drug Glivec, the only known cure for chronic myeloid leukaemia, effective in nine out of ten patients.