NOT for the first time, city bigwigs are attempting to entice people away from European destinations and into York. Yet this campaign has a twist.

These are not tourist chiefs advertising the ancient charms of the Minster to lure in foreign tourists, but doctors promoting the district hospital to bring in British patients.

This is the modern way of health care. Patients are a cash commodity, and health trusts as far apart as Boulogne, Dusseldorf and York compete for the right to treat them.

Whether this is progress or sacrilege depends on your political perspective.

For those sick or in pain, ideology is irrelevant, however. They are only interested in what we might call the Tony Blair test: does it work?

Dr Ian Jackson, leader of the York hospital's day surgery unit, clearly believes it can be made to work. Health Secretary Alan Milburn's experimental plan to send British NHS patients to Europe for surgery is decried as "madness" by Dr Jackson.

He wants to open the day surgery on evenings and at weekends to perform operations on people, mainly from southern England, who would otherwise be despatched to the Continent.

Lateral thinking like this is to be encouraged in an age where health service resources are stretched by insatiable public demand. Now the NHS is run like a business, it makes sense not to allow expensive equipment to lay idle for hours every day.

His proposal also invites many questions, most pertinently about the impact on local patients and staff. We are regularly told of the acute shortage of surgeons and nurses: could the health trust find the extra medical expertise, willing to work unsocial hours, it would require?

Dr Jackson says the plan would bring in more money for local services. But would those on the York waiting list become a lower priority than cash-generating patients from the South?

These concerns must be addressed. We will watch the progress of this initiative with interest.

Updated: 10:40 Friday, October 19, 2001