To ask the Secretary of State for Health what his estimate is of the number of NHS patients who will receive treatment in 2003 in hospitals in EU states outside the UK for (a)hip joint replacements, (b)knee joint replacements, (c)coronary artery by-pass grafts and (d)other cardiac surgical procedures. 
Patients can receive treatment abroad through either the E112 scheme or through direct referral from their national health service trust.No estimate can be provided for the number of patients that will receive treatment in European Union states in 2003 under the E112 scheme. It is usually patients themselves who initiate the application for referrals, but they also need to obtain the support of the United Kingdom specialist doctor responsible for their care and their local health commissioner.The option of referring patients abroad is open to all NHS commissioners and so the number of patients treated abroad will be dependent on the take-up of the scheme by NHS trusts. Overseas treatment will be offered nationally to patients within the choice strategy framework from the end of 2005 as one of several options if alternatives are not available in this country. Before then, overseas treatment will be offered on a localised basis in order to provide a more comprehensive choice for patients to meet local circumstances as well as contestability of provision.
To ask the Secretary of State for Health for how many patients in each of the last five years the NHS has funded treatment in another European Union country. 
Regulation (EEC) 1408/71 is the European legislation that co-ordinates the healthcare schemes of the member states. In principle, each member state is responsible for paying for treatment given to its own insured persons in another member state. The United Kingdom has bilateral cost arrangements with most other member states, the terms of which vary from member state to member state.The main groups of people covered by the Regulation are temporary visitors, referred patients, posted workers and state pensioners who have retired to another member state. Claims from foreign authorities are often aggregated to cover several groups across the whole of the United Kingdom.
There is no central record distinguishing numbers of patients from England. Scotland and Wales treated in other European Union member states. The Department of Health makes settlements in respect of the United Kingdom as a whole.
Information about patients from England, Scotland and Wales referred abroad using the E112 procedure is shown in the table.
Number of E112s issued
In addition to the patients referred abroad under Regulation (EEC) 1408/71, some patients have been referred abroad directly by their National Health Service trust. 190 patients were referred as part of a centrally funded pilot scheme between January and April 2002. Since the pilot, 34 patients were referred by their NHS trust in 2002. A further 218 patients have been referred in 2003 to date. All of these patients were referred abroad by English trusts.
To ask the Secretary of State for Health how many NHS patients have been sent to France for treatment. 
Patients can be referred for treatment abroad under the European Union-wide health care coordination regulations (the E112 scheme), or through direct referral from their national health service trust.The table shows the number of patients referred for treatment in France under each of these systems in 2002, and from 1 January to 31 March 2003.