Private ruling: GST Free supplies of other health services
Date of advice: 22 August 2018
Published: October 2018
Ruling period: Periods commencing 1 January 2017 onward
Date scheme commenced: 1 January 2017

Ruling: Q1: Is the supply of your nutrition consultations services a GST-free supply of other health services, under either: ● Item 7 Dietary, or ● Item 9 Naturopathy of section 38-10 of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act)? | A1: No, the supply of your nutrition consultations services is not a GST-free supply of other health services, under either item 7 or item 9 of section 38-10 of the GST Act.

Relevant facts and circumstances: ● You currently practise nutritional medicine. ● You are registered for GST and report on a quarterly basis. ● You have a bachelor degree in a Related Health Science Medicine ● Your training is the same as a naturopath, but without the liquid herbal medicine aspect. ● Your nutritional medicine consultations regularly cover the same treatments a dietician would do such as dietary planning. ● You are a member of the Australian Relevant Association. ● You have professional indemnity insurance which is provided by an recommended insurer. ● You have provider numbers for health funds that your patients hold a membership. ● The Relevant website states that it: was recognised by the Australian Taxation Office, in November 2002, under a private ruling as '…a professional association that has uniform national registration requirements for practitioners of traditional, complementary medicine and natural therapies…' thereby allowing X practitioners of Acupuncture, Chinese Herbal Medicine, Naturopathy and Western Herbal Medicine to practise GST- free. The Relevant website lists the disciplines recognised and accredited by the Australian Relevant Accreditation Board. These have been listed and form part of the ruling. The Relevant website sets out what treatments are included Natural treatments. These have been listed and form part of this ruling. ● You stated your treatments should be GST free because they meet those of dieticians. ● You are not a member of any other national bodies such as the Dieticians Association of Australia (DAA). The DAA on its website sets out the difference between Dieticians and Nutritionists: A health professional is a tertiary qualified nutrition professional that has the expertise to provide a range of evidence based nutrition services related to nutrition, public health nutrition, policy and research, and community health. There is no industry specific assessing authority that assesses the qualifications of nutritionists who are not dietitians.

Relevant legislative provisions: A New Tax System (Goods and Services Tax) Act 1999 Section 9-5. | A New Tax System (Goods and Services Tax) Act 1999 Subsection 38-10(1). | A New Tax System (Goods and Services Tax) Act 1999 Section 195-1.

Reasons for decision: Summary: Under subsection 38-10(1) of the GST Act, a supply of a health service is GST-free if: (a) the service is of a kind specified in the table in subsection 38-10(1) of the GST Act, or of a kind specified in the GST regulations (b) the supplier is a recognised professional in relation to the supply of services of that kind, and (c) the supply is generally accepted in the relevant profession as being necessary for the appropriate treatment of the recipient of the supply. Each of these requirements must be satisfied for the supply to be GST-free under subsection 38-10(1) of the GST Act. | Detailed Reasoning - Paragraph 38-10(1)(a): The initial focus is on what services you provide. Paragraph 38-10(1)(a) of the GST Act requires that a service must be a service of a kind specified in the table. To qualify, the service must be the provision of one of the actual services listed and not just something similar to one of the services listed. 'Dietary' is specified at in the table and 'Naturopathy' is specified at item 9 in the table. There are no other services listed in the table that specifically relate to nutrition. Item 7 'Dietary' The Tax Office website contains reference to discussions with the Health Industry and in particular ‘Other health services’ which can be found under Issue 2. A question relating to dietary can be found under Health Industry Partnership - Issues Register 2.a.6 What type of recognised professional provides a service of ‘Dietary’ listed at Item 7 of the Table? It is considered that dieticians and nutritionists would in certain circumstances be providing dietary services. From information supplied to the Tax Office it is understood there is only one professional association that may have uniform national registration for the purposes of paragraph (b) of the definition of *recognised professional in section 195-1. This association is the Dieticians Association of Australia. You have advised that you belong to the professional association X which is a separate association to the Dieticians Association of Australia. The X website lists the various disciplines it recognises, however Dietary is not listed. Therefore these two factors indicate that you will not supply Dietary services as listed at Item 7 of the table. Item 9 ‘Naturopathy’ We need to consider whether you supply this service. The professional association you belong to, X, lists amongst other disciplines both Nutrition and Naturopathy. Further in their website they describe what nutrition is and how to gain accreditation with X which includes which courses and colleges X recognises for accreditation. You have a degree in a related field from a recognised College. This is an X recognised Nutrition Course. However, you do not have the X recognised Naturopathy course qualifications, being the Bachelor Health Science (Naturopathy). As such you do not satisfy Item 9 Naturopathy as your accreditation is for nutritional medicine and not naturopathy. As mentioned above, to qualify under paragraph 38-10(1) of the GST Act, the services must be one of the actual services listed and not something similar. The Macquarie dictionary defines the term naturopathy as: a system of treating disease and disorders in humans based on promoting the body's own natural defences, especially by use of herbs, natural foods, massage, exercise and sunlight. You have advised that your training is the same as a naturopath, but without the herbal medicine aspect. Combining the dictionary definition and your training, it is considered that without the herbal aspect you do not meet the definition of naturopathy. | Detailed Reasoning - Paragraph 38-10(1)(b): Under paragraph 38-10(1)(b) of the GST Act, the services must be supplied by a ‘recognised professional’ in relation to the supply of those services. Section 195-1 of the GST Act defines the term ‘recognised professional’. Which for naturopaths or dieticians, requires them to be members of a professional association that has uniform national registration requirements relating to the supply of services of that kind, naturopathy and dietary services respectively. Although you are a member of a professional association that has uniform national registration requirements you are registered as a nutritional medicine provider not a naturopath or dietician. | Detailed Reasoning - Paragraph 38-10(1)(c): For the purposes of paragraph 38-10(1)(c) of the GST Act, the service must be generally accepted in the relevant profession as being necessary for the appropriate treatment of the recipient of the supply. A recognised professional provides treatment when that person assesses the recipient’s state of health and determines a course of action to preserve, restore or improve the physical or psychological wellbeing of that recipient as far as that recognised professionals training allows. The treatment is considered to be appropriate when it would generally be accepted by the relevant profession as being appropriate for the recipient. Therefore, it is the professions themselves that ultimately determine which services are generally accepted as appropriate treatment. Appropriate treatment may include further treatments and may also include preventative medicine. | Detailed Reasoning - Conclusion: Your supply as a health professional does not meet either item 7 or item 9 of the table in subsection 38-10(1) nor does it meet any of the other items in that table. Therefore your supply will not be a GST-free supply of other health services. As you are registered for GST, your supplies will be a taxable supply. Consequently you must remit GST on your supplies and you will be able to claim input tax credits for your expenses with GST in them.