ATO Interpretative Decision

ATO ID 2001/399 (Withdrawn)

Goods and Services Tax

GST and post operative care for cosmetic surgery patients
FOI status: may be released
  • This ATO ID is a straight application of the law and does not contain an interpretative decision.
    This document incorporates revisions made since original publication. View its history and amending notices, if applicable.

CAUTION: This is an edited and summarised record of a Tax Office decision. This record is not published as a form of advice. It is being made available for your inspection to meet FOI requirements, because it may be used by an officer in making another decision.

This ATOID provides you with the following level of protection:

If you reasonably apply this decision in good faith to your own circumstances (which are not materially different from those described in the decision), and the decision is later found to be incorrect you will not be liable to pay any penalty or interest. However, you will be required to pay any underpaid tax (or repay any over-claimed credit, grant or benefit), provided the time limits under the law allow it. If you do intend to apply this decision to your own circumstances, you will need to ensure that the relevant provisions referred to in the decision have not been amended or repealed. You may wish to obtain further advice from the Tax Office or from a professional adviser.

Issue

Is the entity, a supplier of hospital care services, making a GST-free supply under subsection 38-20(1) of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act), when it supplies hospital care services to a patient recovering from cosmetic surgery?

Decision

No, the entity is not making a GST-free supply under subsection 38-20(1) of the GST Act, when it supplies hospital care services to a patient recovering from cosmetic surgery. The entity is making a taxable supply under section 9-5 of the GST Act.

Facts

The entity is a registered private hospital. The entity is providing hospital care to patients recuperating from cosmetic surgery. The hospital care involves accommodation and nursing services.

The cosmetic surgery is not a professional service for which a medicare benefit is payable under Part II of the Health Insurance Act 1973. No post-operative complications, such as infection, develop in the course of supplying the hospital care.

The entity is registered for goods and services tax (GST). The supply satisfies the other positive limbs of section 9-5 of the GST Act.

Reasons for Decision

Under subsection 38-20(1) of the GST Act, a supply of hospital treatment is GST-free.

'Hospital treatment' is defined in section 195-1 as having the meaning given by subsection 67(4) of the National Health Act 1953. 'Hospital treatment' is defined in subsection 67(4) of the National Health Act to mean:

'accommodation and nursing care, whether provided for the purpose of permitting the provision of professional attention or, in the case of a nursing-home type patient, as an end in itself, and includes:

(a)
the provision at, or on behalf of, a hospital of relevant health services to a patient of the hospital; and
(b)
the provision at a hospital of a facility for a patient of the hospital.'

Accordingly, 'hospital treatment' covers supplies of accommodation and nursing services made by the entity to its patients.

However, subsection 38-20(2) of the GST Act provides that a supply of hospital treatment is not GST-free to the extent that it relates to a supply of a professional service that, because of subsection 38-7(2) of the GST Act, is not GST-free.

A service is not GST-free under paragraph 38-7(2)(b) of the GST Act, to the extent that it is rendered for cosmetic reasons and is not a professional service for which a medicare benefit is payable under Part II of the Health Insurance Act.

In this case, the surgery is not GST-free as it has been rendered for cosmetic reasons and is not a professional service for which a medicare benefit is payable under Part II of the Health Insurance Act. No post-operative complications, such as infection, develop in the course of supplying the hospital care.

Therefore, the supply of hospital treatment by the entity is not GST-free under subsection 38-20(1) of the GST Act, as it is directly related to a supply of cosmetic surgery that is not GST-free because of subsection 38-7(2) of the GST Act.

The entity is registered for GST and all the other positive limbs of section 9-5 of the GST Act are satisfied. Furthermore, the supply is neither GST-free under Division 38 of the GST Act, nor input taxed under Division 40 of the GST Act. Therefore, the entity is making a taxable supply under section 9-5 of the GST Act when it supplies accommodation and nursing services to patients recovering from cosmetic surgery.

[Note: The term 'cosmetic reasons' is not defined in the GST Act and is therefore given its ordinary meaning. The Macquarie Dictionary 1997 defines 'cosmetic' as:

serving to beautify; imparting or improving beauty, especially of the complexion;
designed to effect a superficial alteration while keeping the basis unchanged.

A 'medical service' is 'rendered for cosmetic reasons' if it is predominantly performed for, or is rendered for the purpose of permitting, the improvement of the personal appearance of a patient, such as a face-lift. Whether a service is for cosmetic reasons must be evaluated on a case by case basis.
Procedures that alter or enhance a patient's appearance but have no medical or reconstructive purpose are considered to be cosmetic and are not GST-free.
However, a procedure that is performed for medical or reconstructive reasons is not cosmetic and may be GST-free. An example of this is skin grafting performed on a burn victim].

Date of decision:  10 August 2001

Legislative References:
A New Tax System (Goods and Services Tax) Act 1999
   section 9-5
   Division 38
   subsection 38-7(2)
   paragraph 38-7(2)(b)
   subsection 38-20(1)
   subsection 38-20(2)
   Division 40
   section 195-1

Health Insurance Act 1973
   Part II

National Health Act 1953
   subsection 67(4)

Related ATO Interpretative Decisions
ATO ID 2001/400

Other References:
The Macquarie Dictionary, 1997, 3rd edn, The Macquarie Library Pty Ltd, New South Wales.

Keywords
Goods & services tax
GST free
GST health
Hospital treatment
Medical services
GST supplies & acquisitions
Taxable supply

Business Line:  GST

Date of publication:  29 September 2001

ISSN: 1445-2782

history
  Date: Version:
  10 August 2001 Original statement
You are here 18 May 2007 Archived