FEW people can deny feeling at least some trepidation at the prospect of flying. No matter how many times we're told that, statistically, it is the safest form of transport, it still manages to spark emotions ranging from slight nervousness to out-and-out paranoia. But flying is often a necessary evil to be encountered if one wants to escape these shores for some summer sun.

When the plane touches down safely at the destination, a tangible wave of relief ripples through the cabin as the fear, at its height at take-off and easing slightly until the descent, turns to excitement. The scary bit is over, and two weeks of relaxation stretch before you.

The reality, however, brings flying-phobics little reason to rest. Stepping off the aircraft means waving goodbye to one aspect of your trip that is relatively safe.

Your idyllic resort and the freedom you feel while there hold endless potential dangers. Take the taxi to the hotel: there probably won't be seatbelts; the driver will race along poorly planned and maintained roads; the vehicle itself wouldn't pass an MOT test.

You might hire a scooter, but will there be helmets to go with it? For that matter, will you care? You are on holiday after all, with the wind in your hair as you emulate the locals' laid back way of doing things.

Maybe you'll go on a coach trip. On the Greek islands it will probably take you along treacherous mountain roads. Again, there'll be no seatbelts, and as for the bus' history, who knows?

Then there's the hotel, with more potential risks - swimming pools, insects and diseases and the safety of the building itself.

The family of Chris Rochester, from Chester-le-Street, know at first hand the dangers they hide. Chris, 24, died in hospital on the Greek island of Rhodes after falling from the balcony of the apartment where he was staying. But it wasn't the fall that proved fatal. Although conscious immediately afterwards, he died later because, his family claim, of the negligence of hospital staff. Doctors declared he had broken his spine when he hadn't and had died of shock, a theory disproved by a second post mortem examination back in Durham.

There is plenty we can do to reduce the health risks on holiday - having the right vaccinations before travelling, avoiding tap water and raw fruit and vegetables.

When it comes to accidents, while we can take steps to lessen the danger, what can we do to ensure that, if the worst does happen, we get good medical treatment?

When travelling to countries within the European Union, the Foreign Office advises travellers to take an E1-11 form which entitles them to more or less the same level of care expected at home.

The key to medical care abroad, whether in or out of Europe, is comprehensive holiday insurance which covers you not only for the cost but also for the level of care. You should also ensure that all the activities you plan to take part in are covered, for instance skiing off-piste without an instructor may not be.

The most important part of the policy is the emergency medical assistance number which you must ring if you need help. As well as having the telephone number at hand for yourself, your companions should also be aware of it in case you are incapacitated and they can call on your behalf.

In the case of severe injury or illness, the company will have multi-lingual, medically-trained experts who will make contact with the doctors treating you abroad. A spokesman for insurance company Travelplan Direct said: "They will ensure the correct medical procedures are followed and regulate your treatment. Crucially, their presence also tells the hospital that you do have insurance which will pay for whatever treatment is given."

If the experts consider the treatment to be inadequate or if the problem would be better treated at home or in a neighbouring country, the insurance company may arrange for you to be moved by air ambulance. In resorts popular with British holidaymakers, it's likely insurance company doctors, through past experience, will know of the best hospitals and it may be possible to move you within the resort.

However, in an emergency it's likely you will be sent to the nearest A&E department, or to one with which your hotel has an arrangement.

A spokesman for the Foreign Office said: "I don't want to say it's a lottery but you can't always be certain about the level of care and you don't always have a choice where you go."

Good insurance is even more important if you're in a Third World country, somewhere that's known to have poor health care facilities, poor sanitation or widespread Aids; a nation where English isn't widely spoken or if you're travelling independently. Package holidaymakers are likely to have the services of a company representative who should be able to step in and help if a problem does arise.

British Embassy staff around the world are also charged with helping and advising holidaymakers in the case of injury or severe illness but they cannot step in to demand 'better' care. "Consular staff aren't qualified to suggest a holidaymaker should be given a particular treatment or to decide on where someone would be best treated. It would open us up to all kinds of legal challenges," said a Foreign Office spokesman.

Aside from investigating the local facilities before you book and making use of your insurance company's pre-travel advice service, there is little else you can do when it comes to the standards of care abroad. If you're ill or have an accident you really are in the hands of the local health care system with little choice about where or how you're treated, just as you would be in this country.

As holidaymakers visiting nations less developed than our own, we are often shocked at the apparent poor standard of facilities. We like to believe that our emergency system, our health service and hospitals are equipped to ensure we get the best treatment from professionals. In a recent ranking of the world's health systems by the World Health Organisation (WHO), Britain came a favourable 18th out of 191 nations. The position was ahead of Switzerland, Australia and Germany but, interestingly, was behind holiday havens like Malta, Spain, Portugal - and Greece, where Chris Rochester died.

As one insurance company spokesman said: "While holidaymakers may legitimately be concerned about standards overseas, it doesn't necessarily follow that they are better off at home."

Indeed, a growing number of Britons are heading abroad for surgery to avoid lengthy waits in this country, or to see world-renowned specialists. The Ukraine, for example, has a reputation for dealing with back problems and Swiss clinics are known for their cardiosurgery procedures. Other so-called health tourism destinations include Costa Rica for cosmetic surgery and dentistry and Cuba for eye problems and orthopaedic surgery.

The United States, seen by many as the torch bearer in advanced health care, came a poor 37th in the WHO table. Holiday insurance is more crucial there than in most countries because of the prohibitive cost of treatment. If you don't have insurance, care at a reputable hospital will cost thousands of pounds (about £35,000 for a heart attack). If you can't afford it you may be passed from pillar to post while someone is found who will agree to treat you for free with no guarantee of a good standard of care.

Meanwhile, visitors to Britain may have as much cause for complaint as we have when seeking help abroad. Just this week two High Court judges ruled that foreigners should not be entitled to free NHS treatment in the UK after cash provided to pay for Nigerian Olatunji Reffell's treatment ran out.

The answer may be to head for France: it came top of the World Health Organisation's rankings - and you don't have to fly there.

l For travel advice visit the Foreign Office website at www.fco.gov.uk/

For holiday insurance advice visit the Association of British Insurers website at www.abi.org.uk

Travelplan Direct insurance 0800 0188 747

l Tomorrow: how Britain's streets are considered more dangerous than America's