October 17, 2011 • 2:10 pm

“Chancellor George Osborne plans to raise up to £500 million a year by slapping VAT on cosmetic surgery. The move – already being dubbed a ‘boob tax’ by the cosmetics industry – would send the cost of operations such as breast enlargements, facelifts, tummy tucks and liposuction soaring by 20 per cent”. The Mail on Sunday, 16th October 2011.

“The cost of facelifts and breast enlargements is to rise by 20% under new guidelines for VAT on plastic surgery”. The Guardian, 16th October 2011.

The cosmetic surgery industry is up in arms over proposals to charge VAT on procedures put forward by government, according to stories in the Mail on Sunday and the Observer.

Both articles provide quotes from the British Association of Aesthetic Plastic Surgeons (BAAPS) which warn of the potential dangers to patients from the “new guidelines”.

Nevertheless, both articles also carry quotes from HM Revenue and Customs to the effect that, in fact, there would be “no change in government policy on VAT for cosmetic surgery.”

So, are these new guidelines or just a reinforcement of an existing law? Full Fact contacted both HMRC and BAAPS to find out more.

Analysis

HMRC’s Public Notice 701/57 for Health Professionals states exemption from VAT “will only apply to health services supplied by registered health professionals which are intended principally to protect (including maintain or restore) the health of an individual.”

In relation to cosmetic services it asserts that “each case will need to be considered on its individual merits. However, we will generally accept that cosmetic services are exempt where they are undertaken as an element of a health care treatment programme. Where services are undertaken purely for cosmetic reasons, they will be standard rated.”

When we contacted HMRC for comment they said:

“There have been no changes to, nor are there any plans to change, the VAT liability of cosmetic services. Medical care provided by registered health professionals in hospitals or clinics is and will continue to be VAT free, along with cosmetic services carried out for therapeutic purposes. Medical treatment for purely aesthetic reasons has been, and continues to be, liable to VAT at the standard rate.” 

They did however, say that, “HMRC has been undergoing a process of re-writing its VAT public notices to improve clarity and understanding and where necessary, to update them…As part of that work, HMRC has sought to improve the section dealing with cosmetic services and sent a copy of the draft revised notice to trade bodies and other interested parties for consultation. No changes in the VAT liability were proposed or reflected in the draft guidance.

“As a result of the representations, HMRC decided not to amend this part of the Health Professionals public notice at this time while they review the representations and discuss further with the sector on what the clearer guidance should look like. Any revised guidance will, of course, be consulted upon.”

According to HMRC therefore, the ‘changes’ referenced on the Mail on Sunday’s front page boil down to little more than as yet unconfirmed new guidance.

What did BAAPS have to say?

Full Fact contacted former BAAPS President Douglas McGeorge about the issue. He said that although HMRC has not changed the VAT rules by law, they have changed the interpretation of the law, which means in practice there will be a significant increase in the amount of cosmetic surgery being taxed. 

Under the current interpretation of the law, Mr McGeorge stated, no VAT has been charged to date on surgical procedures. Instead it has covered procedures outside the medical setting such as Botox and chemical peels. 

However, if the broader interpretation of the law comes into force, he claimed VAT will be charged on these operations.

Furthermore, he highlighted concerns that HMRC may not be able to effectively distinguish between medical and non-medical procedures, as surgeons will not be able to divulge details to the taxman because of patient confidentiality restrictions.

Conclusion

Essentially, both parties agree there have been no changes to, or plans to change, the current law regarding VAT on cosmetic surgery, something that may not have been clear from the media reporting.

Both parties do however acknowledge that new guidance has been proposed, which could influence how the current laws are interpreted and enforced. BAAPS claim that new interpretations would in effect constitute a change to the law, and that surgical procedures, including breast surgery, would be taxed an extra 20 per cent. Only time will tell whether this new interpretation will be enforced.

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