In the end, Mr Marshall chose to outsource his operation to India. Last month he flew 5,000 miles to the southern Indian city of Bangalore where surgeons at the Wockhardt hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart. The cost was £4,800, including the flight.

"Everyone's been really great here. I have been in the NHS and gone private in Britain in the past, but I can say that the care and facilities in India are easily comparable," says Mr Marshall, sitting in hospital-blue pyjamas. "I'd have no problem coming again."

The 73-year-old found the hospital in Bangalore after a few hours surfing the internet. Mr Marshall decided to come after an email conversation with Wockhardt's vice-president and a chat with other "medical tourists" from Britain who had undergone surgery in the hospital.

"Once I knew others had come I thought, why not? In Europe hospitals in Germany and Belgium would do the operation for less than doctors in Britain. But Europe was still more expensive than here. And the staff speak English in India."