Seventy-five year-old British grandmother Yvonne Watts, suffering from arthritis in her hips, was denied a refund from the British National Health Service (NHS) for the costs of an operation she had abroad in 2003.

Ms Watts had been told by the NHS office in her hometown of Bedford that the waiting time for such an operation would be over a year in England. After a sudden deterioration in health, she underwent €5,700 worth of treatment in France.

Judges in the Luxembourg court deemed that EU rules on freedom to provide services obliges one EU country's healthcare system to pay a domestic patient's bill in another EU country if it can be established that the patient has waited too long.

"The NHS must show that that waiting time does not exceed a medically acceptable period having regard to the patient's condition and clinical needs," the court stated.

The court argued that the setting of waiting times should be done "flexibly and dynamically" and any decision is to be based entirely on the individual patient's medical condition and circumstances on a case-by-case basis.

Ms Watts can now appeal to the British legal system to reconsider reimbursement. The 75 year-old was quoted by media as saying that the news was "wonderful" and that if she got the money back she would donate it to a medical charity.

UK health care costs will sky-rise

UK reactions to the verdict came rapidly, with patient organisations praising the outcome and health officials expressing worries about future UK spending on health care outside its own borders.

"Today's court ruling comes at a time when NHS services in the UK are under the heaviest financial pressure for more than a decade," a spokesperson from British Health Emergency, an organisation linked to the NHS, was quoted as saying.

"We have no doubt that the current round of cutbacks will increase waiting times and that we will see a wave of patients heading to Europe for immediate treatment following today's ruling," he said.

"More money will bleed away from the NHS as the cash follows the patient overseas and that will store up even worse financial problems for the future."

British centre-right MEP Syed Kamall said such fears were uncalled for however. "Patients deserve choice over their treatment and now they will have more options available to them if it looks like the NHS cannot deliver," the MEP said in a statement.

"I doubt there will be a flood of patients choosing to have their operations in France but at least people now know they have that option available to them."

Brussels should set rules

Reacting to Tuesday's verdict in Luxembourg, UK conservative MEP and European Parliament rapporteur on health issues, John Bowis, said it was time the EU got a grip on the rules surrounding medical treatment abroad, rather than leaving it up the courts to decide in individual cases.

"We need a Europe-wide code for patient mobility," Mr Bowis told the EUobserver, explaining that such a rule would create broader certainty not only for patients but for doctors, insurance companies and everybody involved in the health chain.

"The EU has to establish a mechanism for payments, insurances, cross-border and cross-currency payments and, finally, cross-border complaint system."

Mr Bowis also suggested that Brussels set up a health information system for citizens and that each member state bring forward a "waiting-time tariff list" for benchmarking purposes.

"The waiting time tariff can depend on whether the patient is a child or an elderly person, or of the state of the patient's illness - but there should be some time scope set up," he added.