Commentary

V4.147 Exemption for health and welfare—practitioners

Part V4 Exemption, zero-rating and reduced rates

V4.147 Exemption for health and welfare—practitioners

V4.147 Exemption for health and welfare—practitioners

Supply of care as distinct from supply of staff

It should be noted that the exemption under VATA 1994, Sch 9, Group 7, Items 1–4 (and 5, in the view of the Tribunal – see 'VATA 1994, Sch 9, Group 7, item 5 (deputies)' below) relates to the supply of care and associated goods, but not to the supply of medical staff (although there is a concession in relation to the supply of nursing staff – see under that head below). Thus the question may arise as to that nature of what is being supplied.

In City Fresh1, two dentists, acting in partnership (CDP), set up a company (City Fresh) through which they supplied their services to CDP. CDP then supplied the services on to an NHS Trust. HMRC argued that the arrangement meant that City Fresh was making taxable supplies of staff, rather than exempt dental services, on the grounds that the dentists came under the control of CDP. The Tribunal held, however, that although there was an intervening entity, CDP, between the providers of the dental services and the ultimate recipient, the NHS Trust, there was no evidence that CDP changed the nature of the supply or that there was a change of control from City Fresh to CDP over the dentists' activities. It was clear that the two dentists provided only dental services to CDP and their day to day activities when they were acting through City Fresh were exactly the

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