Upper Tribunal: Mainpay Ltd v HMRC – Exempted medical services

Upper Tribunal Tax and Chancery decision of Mr Justice Mellor and Judge Guy Brannan on 3 November 2021

Whether a supply of medical care by company supplying consultants and GP Specialists indirectly to NHS– Group 7 Schedule 9 VATA 1994 and Article 132 of the Principal VAT Directive.

Mainpay maintains that it contracts with A&E to provide services in the form of medical care directly to NHS Trusts. Pursuant to the agreement it retains responsibility for those services. Consultants are not under the control of NHS Trusts as regards the medical care they provide to patients and the clinical decisions they take in relation to patients. No-one other than the individual Consultant has control over such care and decisions. Mainpay has control over the assignments carried out by Consultants, including where and when those assignments are carried out. It considers that in a supply of staff, control of the individual must be given to the client. Because the Consultants do not come under the control of the NHS Trusts, its supply cannot be a supply of staff. Moreover, it retains contractual responsibility for the way in which the services are performed, which is consistent with a supply of medical care and not with a supply of staff.

The FTT held that in relation to Consultants’ services Mainpay supplied staff and not medical care. That supply was standard-rated for VAT purposes. The FTT was not satisfied that the position was any different in relation to GP Specialists.

Source gov.uk

See also

• ECJ: Focus on ”Exemption for hospital & medical care” (Art. 132(1)(b))
• ECJ: Focus on ”Exemption – Provision of medical care in the exercise of the medical and paramedical professions” (Art. 132(1)(c))

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