Need a new liver? Why not head to France. A hip replacement? Japan could be the place for you.

According to a leaked document, the highly secretive Trade in Services Agreement (TiSA) negotiations that will resume in Geneva on Monday will include discussion of wide-ranging reforms to national public health systems to promote "offshoring" of health care services.

Trade Minister Andrew Robb. Credit:Sanghee Liu

But health unions and trade experts say the negotiations, which are being led by Australia, the US and the European Union, could lead to massive growth of "medical tourism" to the detriment of investment in Australian public hospitals and local healthcare.

The leaked discussion paper – published by the non-government organisations Associated Whistle-Blowing Press and Public Services International – has for the first time revealed TiSA countries including Australia are actively discussing measures to boost the "cross-border delivery of health services".