This may mark the beginning of the end of the health service

The nine patients who arrived at La Louviere Hospital in Lille may turn out to be the most important patients in the NHS's 53-year history.

In as little as five years' time we will, quite possibly, look back at their cross-Channel hop as marking the beginning of the end of the NHS. Not because of the numbers involved, which are never going to be more than a few thousand, but because of the impact the trip will have on the way we see our health service.

Soon we will all know of someone who has benefited. And we will all be asking the same question: how come the rest of Europe can provide health services, and we can't?

Just as it makes perfect sense for the NHS to buy surplus services from the private sector, so, too, it is sensible for patients who can't be treated in the UK to go abroad.

Ignore for a moment the national shame implicit in yesterday's development – that we are reduced to exporting patients because the NHS has become so weak. To see how devastating such journeys may turn out to be for the NHS's future, we need to look at the reasons why we can't treat our patients, while continental systems can treat not only their own, but ours too.

The answer is straightforward: the NHS is a monopoly, and continental systems are not. That matters not just in terms of the provision of services, but also in the way they are funded.

The Health Secretary, Alan Milburn, is right to try to open up the NHS so that, as on the Continent, services are delivered by many different types of organisations, from mutuals and charitable trusts to profit-making companies. But it is missing a crucial part of the equation to look at the Continent, see that they use all sorts of providers, and think that if we did the same and increased our spending everything will come right. The differences in the methods of funding is equally critical.

Instead of the NHS method – tax, which involves money being handed over to the Government to be spent on our behalf – continental systems evolved with responsiveness to the patient at their heart. Sometimes the patient pays the service and is then reimbursed, sometimes the service is paid via insurance. But if services don't attract patients, then they don't get revenue.

Mr Milburn talks about the need to make the NHS more responsive. For that to be the case, patients need to have a real choice. And that means they must have control over where their money is spent.

It is no accident that continental systems have more money and more resources: patients choose to spend their money on health because they can see that it is put to good to use.

Just as a state-run, state-funded grocer would never be able to provide the same level of service as a Sainsbury or a Tesco, so a state-run and state-funded health service cannot match what is provided by continental systems.

Stephen Pollard is a senior fellow at the Centre for the New Europe, a think-tank based in Brussels