Opinion of the Advocate General — ECLI:EU:C:2010:453
Date: 2010-07-29
Language of the case: German
Subject matter: Taxation;Value added tax
Procedure: Reference for a preliminary ruling
Origin: Germany

Summary of the Judgment Tax provisions – Harmonisation of laws – Turnover taxes – Common system of value added tax – Exemptions provided for in the Sixth Directive – Exemption regarding the provision of medical care in the medical and paramedical professions – Scope (Council Directive 77/388, Art. 13(A)(1)(c)) Article 13(A)(1)(c) of Sixth [Council] Directive 77/388 on the harmonisation of the laws of the Member States relating to turnover taxes, as amended by Directive 95/7, must be interpreted as meaning that the removal of joint cartilage cells from cartilage material taken from a human being and the subsequent multiplication of those cells for reimplantation for therapeutic purposes constitute ‘provision of medical care’ in accordance with that provision. The concept of ‘provision of medical care’ is intended to cover services having as their purpose the diagnosis, treatment and, in so far as possible, cure of diseases or health disorders. Whilst the provision of medical care must have a therapeutic purpose, it does not necessarily follow that the therapeutic purpose of a service must be confined within a particularly narrow compass. In that regard, the fact that the services are carried out by laboratory staff who are not qualified medical practitioners is irrelevant, inasmuch as it is not necessary for every aspect of therapeutic care to be provided by medical staff. Moreover, whether the multiplied cells are reimplanted into the patient from whom they were originally removed or another patient has no bearing on the classification of a service as ‘the provision of medical care’. (see paras 24, 28-29, 32, operative part)