This is not a view in Arizona because Robertson is in Jaslok Hospital in Bombay, watching the sun set over the Arabian Sea. He is one of 150,000 foreigners who seek treatment in Indian hospitals for non-emergency conditions every year, taking advantage of sophisticated medicine at very low cost.

Surprised by unexpected visitors, he says, joking: “I hope these people aren’t here to hand me any bills.” His package of treatment and travel was arranged online by a Canadian agency and he agreed the surgeon and hospital.

He needed a Birmingham hip replacement, which is difficult to obtain in the United States, and cost was an issue. “I’m not insured — it’s on my funds. It’s a fraction of the cost in the United States,” he says.

There are only 12 foreign patients in Jaslok, a charitable foundation with 376 beds. It offers 51 beds free to the poor and another 87 at concessional rates, all subsidised by the fees paid by its wealthier patients, including visiting Americans and some Britons.

According to Taj Medical Group, a knee operation that might cost £10,000 in the UK can be obtained in India for £4,900, including travel and accommodation. Patients seeking minor surgery combine their treatment with holidays at posh resorts, which are included in the price.

It is a business growing at double-digit rates, worth $300 million (£170 million) annually for India. Taj Hotels, unrelated to the Taj medical group, is soon to announce a tie-up with Apollo Hospitals, a private medical group, to promote and exploit the soaring demand for cheaper medicine.

BUPA is sending patients to Jaslok, says Colonel Masand, the hospital’s director-general. The NHS, however, is proving reluctant despite the cost advantage and the promise of almost immediate treatment for chronic conditions, such as hip and knee problems. The NHS yesterday denied that it had sent any patients to India or planned to do so but declined to give any explanation for the policy.

The NHS can have little medical reason for its policy. Jaslok is not a swish private clinic but if transplanted to the UK its unglamorous decor would pass muster in the NHS. Jaslok’s Indian staff are unremarkable, many having trained in Britain or America, and its diagnostic equipment includes the latest kit manufactured by Siemens, the German electronics giant. Only the shrine adjacent to the main entrance, with statues of Vishnu and Lakshmi, hints at where you are.

If the NHS is a bit prim about Indian medicine, others are bullish, including Siemens, which sees a huge market for its medical technology, worth $1.3 billion and expected to double in size within five years.

It is not only medical tourism but offshore diagnostics that offers huge opportunities for India, says Dhandapany Ragavan of Siemens Medical Solutions. The annual salary of a top radiologist in the US might be $300,000, compared with $20,000 in India. X-ray images are already being sent overnight from the US to be read by Indian radiologists. “It is only a question of time before public institutions send patients to India to reduce healthcare costs,” Ragavan says.

At Taj Medical, they are already seeing UK patients that the public service rejects. “The Government has told obese people they will not have operations unless they lose weight, which is a problem if they have hip or knee problems and cannot exercise.”

But a spokesman for the NHS says that “patients have a choice of four hospitals and will be treated within six months”.

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