Opinion of the Advocate General — ECLI:EU:C:2003:59
Date: 2003-01-30
Based on: Treaty establishing the European Economic Community (1957)
Subject matter: Taxation;Value added tax
Procedure: Reference for a preliminary ruling
Origin: Austria;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 
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SUMMARY — CASE C-212/01 
medical care provided in the exercise of the medical and paramedical professions — 
Scope — Expert medical report in connection with the grant of a disability pension — 
Excluded 
(Art. 13A(1)(c) of Council Directive 77/388) 
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 taking a decision with legal con­
sequences, the exemption does not apply to 
the service. 
Thus, Article 13A(1)(c) is to be interpreted 
as meaning that the exemption from value 
added tax under that provision does not 
apply to the services of a doctor consisting 
of making an expert report on a person's 
state of health in order to support or 
exclude a claim for payment of a disability 
pension. The fact that the medical expert 
was instructed by a court or pension insur­
ance institution is irrelevant in that respect. 
(see paras 35, 42, 45, operative part) 
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