«(Sixth VAT Directive – Exemption for medical care provided in the exercise of the medical and paramedical professions)»

Tax provisions – Harmonisation of laws – Turnover taxes – Common system of value added tax – Exemptions provided for by the Sixth Directive – Exemption for medical care provided in the exercise of the medical and paramedical professions – Scope (Art. 13A(1)(c) of Council Directive 77/388) Article 13A(1)(c) of Sixth Directive 77/388, relating to the exemption from value added tax of certain medical services, does not exempt all the services which may be effected in the exercise of the medical and paramedical professions, but only provision of medical care.In that regard, it is the purpose of a medical service which determines whether it should be exempt from VAT. Therefore, if the context in which such a service is effected enables it to be established that its principal purpose is not the protection, including the maintenance or restoration, of health but rather the provision of advice required prior to the taking of a decision with legal consequences, the exemption does not apply to the service.Thus, Article 13A(1)(c) is to be interpreted as meaning that the exemption from VAT under that provision applies to medical services consisting of:─ conducting medical examinations of individuals for employers or insurance companies,─ the taking of blood or other bodily samples to test for the presence of viruses, infections or other diseases on behalf of employers or insurers, or─ certification of medical fitness, for example, as to fitness to travel,where those services are intended principally to protect the health of the person concerned.On the other hand, the said exemption does not apply to the following services, performed in the exercise of the medical profession:─ giving certificates as to a person's medical condition for purposes such as entitlement to a war pension,─ medical examinations conducted with a view to the preparation of an expert medical report regarding issues of liability and the quantification of damages for individuals contemplating personal injury litigation,─ the preparation of medical reports following examinations referred to in the previous indent and medical reports based on medical notes without conducting a medical examination,─ medical examinations conducted with a view to the preparation of expert medical reports regarding professional medical negligence for individuals contemplating litigation,─ the preparation of medical reports following examinations referred to in the previous indent and medical reports based on medical notes without conducting a medical examination.see paras 53, 60, 68-69, operative part 1-2

JUDGMENT OF THE COURT (Fifth Chamber) 20 November 2003 (1)

((Sixth VAT Directive – Exemption for medical care provided in the exercise of the medical and paramedical professions))

In Case C-307/01,

REFERENCE to the Court under Article 234 EC by the VAT and Duties Tribunal, London (United Kingdom), for a preliminary ruling in the proceedings pending before that tribunal between

and

on the interpretation of Article 13A(1)(c) of Sixth Council Directive 77/388/EEC of 17 May 1977 on the harmonisation of the laws of the Member States relating to turnover taxes ─ Common system of value added tax: uniform basis of assessment (OJ 1977 L 145, p. 1),

THE COURT (Fifth Chamber),,

composed of: A. Rosas (Rapporteur), acting for the President of the Fifth Chamber, D.A.O. Edward and A. La Pergola, Judges,

Advocate General: C. Stix-Hackl,

after considering the written observations submitted on behalf of:

having regard to the Report for the Hearing,

after hearing the oral observations of Dr d'Ambrumenil and of Dispute Resolution Services Ltd, of the United Kingdom Government and of the Commission, at the hearing on 20 November 2002,

after hearing the Opinion of the Advocate General at the sitting on 30 January 2003,

gives the following

Community law

...

...

....

National legislation

Observations submitted to the Court

The Court's reply

where those services are intended principally to protect the health of the person concerned.

On those grounds,

THE COURT (Fifth Chamber),

in answer to the question referred to it by the VAT and Duties Tribunal, London, by decision of 6 June 2001, hereby rules:

Rosas

Edward

La Pergola

Delivered in open court in Luxembourg on 20 November 2003.

R. Grass

V. Skouris

Registrar

President