Complementary Medicine and VAT (Hansard, 23 June 1986)

§ Viscount Massereene and Ferrard
My Lords, I beg leave to ask the second Question standing in my name on the Order Paper.

§ Lord Brabazon of Tara
My Lords, in the area of health care, exemption from VAT has applied since the introduction of the tax to supplies by persons who are registered or enrolled on any of the statutory medical registers. This provides a clear borderline which is understood by all concerned and generally accepted as reasonable.

§ Viscount Massereene and Ferrard
My Lords, I thank my noble friend for that Answer. Is he aware that something over 2,000 qualified medical practitioners in the therapies have studied for many years in these therapies? Will he not agree that there should be some institute—perhaps under the auspices of the BMA—to register these practitioners and to see that they are fully qualified in the therapies that they have studied? Will he not agree that by having VAT the Government are putting a tax on the freedom of choice for medical attention on these patients who prefer to have therapeutic treatment?

§ Lord Brabazon of Tara
My Lords, it is open to any of these people to apply to the Council for Professions Supplementary to Medicine for exemption under the Professions Supplementary to Medicine Act 1960. If they were listed or registered by the council, they would be exempt from VAT. I suggest that it is certainly not a matter which should be decided by the VAT inspector. The best route is for them to apply to be registered, and if they were successful, they would be exempt.

§ Lord Ennals
My Lords, is this not a matter which should be carefully examined by the Government? There is widespread and growing interest in it, and obviously these two Questions are linked. Bearing in mind that qualified doctors—GPs—do not have to pay VAT but qualified practitioners of complementary medicine do, is there not some injustice in this? Will the Government now decide that the time has come to look again at this issue?

§ Lord Brabazon of Tara
My Lords, as I have just said, the machinery exists. Under the Professions Supplementary to Medicine Act 1960 it is open to any of these bodies to apply to the Council for Professions Supplementary to Medicine, and if they can get on the register through that route, their services will be exempt from VAT.

§ Lord Ennals
My Lords, with respect, that really does not answer the question. My question implied that the Government have some responsibility here; it is not just the professions supplementary to medicine. I asked the noble Lord—and I ask him again—to draw 4 the attention of his right honourable friend the Secretary of State for Social Services to the exchange that has taken place in order that the Government themselves may take a position on this.

§ Lord Brabazon of Tara
My Lords, I shall certainly draw these exchanges to the attention of my right honourable friend the Secretary of State for Social Services, but at the end of the day my right honourable friend is responsible for decisions or, if there is a dispute, for the decision of the Council for Professions Supplementary to Medicine. Therefore, I would suggest that it is easier for any groups, such as osteopaths, to apply first to the council and, pending the result, if necessary to go to the Secretary of State. I certainly do not think that it would be right for the VAT inspector to be the person to take this decision.

§ Lord Cullen of Ashbourne
My Lords, is my noble friend aware that it is recognised throughout Europe that tax should not be paid on the provision of medical or paramedical services, and that the levying of such a tax is contrary to Article 13(A)(l)(c) of the Sixth Directive? Is he further aware that it is high time that the General Council for Registered Osteopaths, which has been in existence for nearly 40 years, is recognised as an actively professional body whose practitioners are practising the medical art?

§ Lord Brabazon of Tara
My Lords, far be it from me to discuss the merits or demerits of any particular group of medical practitioners. All I can say is that all the main medical practitioners are exempt from VAT at the moment: doctors, dentists, opticians, nurses, midwives and, in addition, those who qualify under the Professions Supplementary to Medicine Act; that is to say, chiropodists, dieticians, etc. If osteopaths wish to join in that group, it is for them to apply, and if they get on the register, they will not have to pay VAT.

§ Lord Ferrier
My Lords, what about chiropractors? This Question refers to VAT on fees. What is the use of their qualifying if the DHSS, presumably under the instruction of the BMA, is not prepared to accept that they are qualified to practise their complementary medicine? As I suggested in my last question, is this not a matter for proper examination, so that provision is made for qualified people to be accepted under the DHSS? The question of finance is very important.

§ Lord Brabazon of Tara
My Lords, I really have nothing further to add than that the chiropractors should apply to the Council for Professions Supplementary to Medicine in order to get on its register and therefore be exempt.