Keywords
Summary

Keywords

Tax provisions – Harmonisation of laws – Turnover taxes – Common system of value added tax – Exemptions laid down by the Sixth Directive – Exemption for hospital and medical care and closely related activities – Definition of ‘closely related activities’ and of ‘medical care’ – Provision of telephone services and the hiring out of televisions to in-patients and the provision of beds and meals to persons accompanying them – Not included – Exception – Conditions – Assessment by the national court

(Council Directive 77/388, Art. 13(A)(1)(b))

Summary

The supply of telephone services and the hiring out of televisions to in-patients by persons covered by Article 13A(1)(b) of Sixth Directive 77/388 on the harmonisation of the laws of the Member States relating to turnover taxes, and the supply by those persons of beds and meals to people accompanying in-patients do not amount, as a general rule, to activities closely related to hospital and medical care within the meaning of that provision. The exemption of such activities provided for in Article 13A(1)(b) of the Directive is designed to ensure that access to such care is not prevented by the increased costs of providing it that would follow if it, or closely related activities, were subject to value added tax. The hospital and medical care envisaged by this provision is, according to the case‑law, that which has as its purpose the diagnosis, treatment and, in so far as possible, cure of diseases or health disorders. Accordingly, taking account of the objective pursued by the exemption provided for in Article 13A(1)(b) of the Sixth Directive, it follows that only the supply of services which are logically part of the provision of hospital and medical-care services, and which constitute an indispensable stage in the process of the supply of those services to achieve their therapeutic objectives, is capable of amounting to ‘closely related activities’ within the meaning of that provision.

The supply of those services can amount to a ‘closely related’ activity only if those supplies are essential to achieve the therapeutic objectives sought by the hospital and medical care and their basic purpose is not to obtain additional income for the supplier by carrying out transactions which are in direct competition with those of commercial enterprises liable for value added tax. It is for the referring court, taking account of all of the specific facts in the litigation before it and, if appropriate, of the content of the medical prescriptions drawn up for the patients concerned, to determine whether the services supplied satisfy those conditions.

(see paras 23-25, 30, 35, operative part 1-2)