Finanzamt Leverkusen v Verigen Transplantation Service International AG.
Date: 2010-11-18
21. It should be noted at the outset that under the Sixth Directive the scope of VAT is very wide in that Article 2 thereof, which concerns taxable transactions, refers not only to the importation of goods but also to the supply of goods or services effected for consideration within the territory of the country by a taxable person acting as such (see, in particular, Case C‑255/02 Halifax and Others  [2006] ECR I‑1609, paragraph 49; Case C‑401/05 VDP Dental Laboratory  [2006] ECR I‑12121, paragraph 22; and Case C‑262/08 CopyGene  [2010] ECR I‑0000, paragraph 23).
22. Article 13 of the Sixth Directive nevertheless exempts certain activities from VAT. It is settled case-law that the exemptions referred to in that article constitute independent concepts of European Union law whose purpose is to avoid divergences in the application of the VAT system as between one Member State and another (see, in particular, Case C‑349/96 CPP  [1999] ECR I‑973, paragraph 15, and CopyGene , paragraph 24).
23. The settled case-law further shows that the terms used to specify the exemptions in Article 13 of the Sixth Directive are to be interpreted strictly, since they constitute exceptions to the general principle that VAT is to be levied on all goods and services supplied for consideration by a taxable person. Nevertheless, the interpretation of those terms must be consistent with the objectives pursued by those exemptions and comply with the requirements of the principle of fiscal neutrality inherent in the common system of VAT. Thus, the requirement of strict interpretation does not mean that the terms used to specify the exemptions referred to in Article 13 must be construed in such a way as to deprive the exemptions of their intended effect (see, in particular, Case C‑445/05 Haderer  [2007] ECR I‑4841, paragraph 18 and the case-law cited, and CopyGene , paragraph 26 and the case-law cited).
24. As regards the exemption referred to in Article 13(A)(1)(c) of the Sixth Directive, it follows from the case-law that the concept of ‘provision of medical care’ is intended to cover services which have as their purpose the diagnosis, treatment and, in so far as possible, cure of diseases or health disorders ( CopyGene , paragraph 28 and the case-law cited). Whilst the provision of medical care must have a therapeutic purpose, it does not necessarily follow, according to the case‑law cited in the previous paragraph, that the therapeutic purpose of a service must be confined within a particularly narrow compass (see CopyGene , paragraph 29 and the case-law cited).
27.  It follows from the foregoing that the extraction of joint cartilage cells from cartilage material taken from a human and the subsequent multiplication of the cells for reimplantation for a therapeutic purpose falls within the concept of ‘provision of medical care’ referred to in Article 13(A)(1)(c) of the Sixth Directive. Such an interpretation is also consistent with the objective of reducing the cost of health care referred to in that provision (see Case C‑106/05 L.u.P.  [2006] ECR I‑5123, paragraph 29).
28. 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 (see, to that effect, Case C‑141/00 Kügler  [2002] ECR I‑6833, paragraph 41, and L.u.P. , paragraph 39).
29. Moreover, it should be added that whether the multiplied cells are reimplanted into the patient from whom they were originally removed or another patient has, as a rule, no bearing on classification of a service as ‘the provision of medical care’ (see, by analogy, CopyGene , paragraph 51).