Judgment — ECLI:EU:C:2003:627
Date: 2003-11-20
Based on: Treaty establishing the European Economic Community (1957)
Subject matter: Taxation;Value added tax
Concepts: Provision of medical care in exercise of medical and paramedical professions
Procedure: Reference for a preliminary ruling
Origin: United Kingdom

Summary of the Judgment 
Tax provisions — Harmonisation of laws — Turnover taxes — Common system of 
value added tax — Exemptions provided for by the Sixth Directive — Exemption for 
medical care provided in the exercise of the medical and paramedical professions — 
Scope 
(Art. 13A(1)(c) of Council Directive 77/388) 
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SUMMARY - CASE C-307/01 
Article 13A(1)(c) of Sixth Directive 77/388, 
relating to the exemption from value added 
tax of certain medical services, does not 
exempt all the services which may be 
effected in the exercise of the medical and 
paramedical professions, but only 'provi­
sion of medical care'. 
In that regard, it is the purpose of a medical 
service which determines whether it should 
be exempt from VAT. Therefore, if the 
context in which such a service is effected 
enables it to be established that its principal 
purpose is not the protection, including the 
maintenance or restoration, of health but 
rather the provision of advice required 
prior to the taking of a decision with legal 
consequences, the exemption does not 
apply to the service. 
Thus, Article 13A(1)(c) is to be interpreted 
as meaning that the exemption from VAT 
under that provision applies to medical 
services consisting of: 
— conducting medical examinations of 
individuals for employers or insurance 
companies, 
— the taking of blood or other bodily 
samples to test for the presence of 
viruses, infections or other diseases on 
behalf of employers or insurers, or 
— certification of medical fitness, for 
example, as to fitness to travel, 
where those services are intended prin­
cipally to protect the health of the person 
concerned. 
On the other hand, the said exemption does 
not apply to the following services, per­
formed in the exercise of the medical 
profession: 
— giving certificates as to a person's 
medical condition for purposes such 
as entitlement to a war pension, 
— medical examinations conducted with 
a view to the preparation of an expert 
medical report regarding issues of 
liability and the quantification of 
damages for individuals contemplating 
personal injury litigation, 
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D'AMBRUMENIL AND DISPUTE RESOLUTION SERVICES 
— the preparation of medical reports 
following examinations referred to in 
the previous indent and medical reports 
based on medical notes without con­
ducting a medical examination, 
— medical examinations conducted with 
a view to the preparation of expert 
medical reports regarding professional 
medical negligence for individuals con­
templating litigation, 
— the preparation of medical reports 
following examinations referred to in 
the previous indent and medical reports 
based on medical notes without con­
ducting a medical examination. 
(see paras 53, 60, 68-69, 
operative part 1-2) 
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