Edited version of private advice

Authorisation Number: 1051539071507

Date of advice: 04 July 2019

Ruling

Subject: Goods and services tax (GST) and other health services

Question

Is the service a GST-free supply under section 38-10 of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act) when it is not provided under the supervision of a medical practitioner?

Answer

The supply will be GST-free if it is generally accepted by the profession as necessary for the appropriate treatment of the recipient of the supply.

The scheme commences on:

The date of issue of this notice of private ruling.

Relevant facts and circumstances

You provide a service. This service is available to anyone who wishes to book an appointment.

The service is provided by trained staff, but is not under the direct supervision of a medical doctor. The patient does not need a referral from a doctor.

The procedure is administered in a medical style consulting room with specialist equipment similar to the equipment used in a doctor's surgery.

Customers seek this service because they have an ongoing problem that needs regular attention.

Prior to this new technique being available, patients used to consult their local general practising doctor. This service is a GST-free service because it has been supervised by a doctor.

You contend that regular nursing of the complaint is the best form of treatment and that the process be considered "Nursing" and therefore not subject to GST.

The supply of this procedure is not subsidised by Medicare. If the treatment was done in a medical surgery it would be subsidised by Medicare.

Relevant legislative provisions

A New Tax System (Goods and Services Tax) Act 1999 section 38-10

Reasons for decision

Health services that are not defined as medical services are GST-free under section 38-10 of the GST Act if all of the following apply:

·         it is a listed health service

·         the service is performed by a recognised health professional in that listed health service or under certain circumstances their assistant

·         the service is generally accepted in that listed health profession as being necessary for the appropriate treatment of the recipient of the supply.

Listed health services

·         an Aboriginal or Torres Strait Islander health service

·         acupuncture

·         audiology or audiometry

·         chiropody

·         chiropractic

·         dental

·         dietary

·         herbal medicine (including traditional Chinese herbal medicine)

·         naturopathy

·         nursing

·         occupational therapy

·         optometry

·         osteopathy

·         paramedical

·         pharmacy

·         psychology

·         physiotherapy

·         podiatry

·         speech pathology

·         speech therapy

·         social work.

You are aware that the only listed service that may apply to you is that of Nursing.

Recognised health professionals

A recognised health professional is a person who is registered, permitted or approved under state or territory law to provide the listed health service.

Nurses and midwives must be registered with the Nursing and Midwifery Board of Australia, and meet the NMBA's registration standards, in order to practise in Australia.

Appropriate treatment

A health professional is supplying appropriate treatment when they use their professional skills to:

·         assess a patient's health

·         work out a course of action to preserve, restore or improve the patient's physical or psychological wellbeing, as far as the practitioner's training allows

·         supply a treatment that is generally accepted by their profession as being appropriate for the patient.

Appropriate treatment includes preventative medicine and routine check-ups. For example, procedures such as pap smears, breast cancer screening and vaccinations are GST-free as they are appropriate for the people involved.

In addition, section 38-10 requires that the treatment must be generally accepted in the profession as being necessary. The particular service being provided by the registered nurse and the circumstances in which it is provided must be generally accepted by the nursing profession. The words 'generally accepted in the profession' indicate that it will ultimately be the nursing profession that determines what services will be generally accepted.

As such, your supply will satisfy all of the requirements under subsection 38-10(1) of the GST Act if the service is generally accepted by the nursing profession as necessary for the appropriate treatment of the recipient of the supply. If so, you are making a GST-free supply under subsection 38-10(1) of the GST Act.