“VATHLT2300 of the VAT Internal Guidance acknowledges that psychiatrists are registered medical practitioners which make their services potentially exempt under item 1(a) to Group 7. The conditions for exempting services supplied by health professionals are set out at paragraph 2.3 in the VAT Notice 701057 - Health professionals. They are: ‘1. The services are within the profession in which you are registered to practice. 2. The primary purpose of the services is the protection, maintenance or restoration of the health of the person concerned.’ The European law vires for exempting medical care under item 1 of Group 7 is Art 132 (1) (c). This states that - ‘Member States shall exempt the following transactions: (c) The provision of medical care in the exercise of the medical and paramedical professions as defined by the Member State concerned.’ The ECJ in the case of Dornier ((20031 EUECJ C-40) held that the "provision of medical care" in what was then Art 13A (1) (c) of the VAT Sixth Directive (now Art 132(1) (c) of the PVD) must have as its purpose the diagnosis, treatment and, in so far as possible, cure of the diseases or health disorders (para 48 of the judgment refers). Further, the ECJ in the case of PL dArnbrumenil and Dispute Resolution Services (C-307/01) held that the VAT exemption afforded by Art 132(1) (c) is restricted to `medical care", which it defined as those services intended principally to protect (including maintain or restore) the health of an individual.”
‘It is our client's intention to seek to recover VAT which should have been charged to her clients, by means of VAT only invoices. If she is successful in this respect then the VAT to be reported in her returns from the date of the effective registration, will be on the basis of applying the relevant VAT rate to the amounts previously invoiced without VAT. However it may be that in some cases she is not able to charge the VAT now. This may be a matter of contract law between the parties and may take some time to resolve. Where, under the terms of a contract with clients, any VAT cannot now be billed to them, the VAT to be included in the returns ought to be on the basis of the appropriate VAT fraction applied to the previous invoices. Similarly, where VAT is legally billable to clients now, but for whatever reason a client does not pay, VAT bad debt relief would be due.’
‘It is clear that in these cases the client has paid the net amount in full (as it is the net amount which was originally invoiced) and therefore the amount remaining unpaid is wholly attributable to the VAT element which has been separately invoiced. On this basis no VAT will be due from our client.’
‘If your customer refuses to pay the VAT charged, or you did not charge when the supplies were made but issued supplementary invoices to recover the VAT from your customer, the claim to relief is limited to the VAT element of the total debt.’
‘The taxpayer made an honest mistake in not charging VAT on its supplies of psychiatric services in respect of medico-legal work. Supplies of psychiatric services to patients are exempt and for this reason the taxpayer did not believe that any VAT was due and that VAT registration was not required. Following professional advice, the view of HMRC was sought and it was agreed that VAT registration should have taken place and VAT charged on supplies. A part of the taxpayer's business involves taking instructions from solicitors to prepare psychiatric reports on individuals for the purpose of Court proceedings. The charges of these are billed to solicitors and charged to the individuals, almost all of whom are funded by legal aid. Following VAT registration, attempts were made to recover the previously uncharged VAT by issuing VAT only invoices to the relevant solicitors. In a few instances the solicitors paid these and those amounts have been paid over to HMRC. In most cases (sic) however (sic) the solicitors have closed the relevant case files and completed their returns to the relevant Legal Aid Board. We understand that it is not possible for these files to be reopened and for the Legal Aid Board to now pay the VAT due. If the taxpayer is now required to pay the VAT, this will result in an unjust enrichment to the State. If the VAT had been paid by the Legal Aid Board and then paid over to HMRC the position of the State would be neutral as tax revenues fund the Legal Aid Board. The VAT would have flowed in a circle with no net cost to anyone. If HMRC is now to collect the VAT from the taxpayer the cost will fall on the taxpayer and the State will be better off by the amount of VAT collected. This would constitute an unjust enrichment and it would be at the expense of the taxpayer.’