The taxpayer, a private medical clinic trading as the Dr Darren McKeown Aesthetic Medicine Institute, was subject to a VAT enquiry by HMRC. HMRC determined that almost all of the clinic’s supplies were standard rated and issued a decision that the taxpayer was liable to be VAT registered. The clinic argued that its turnover from purely cosmetic treatments was below the registration threshold and the rest were exempt. The case involved a detailed examination of evidence and legal principles related to the medical care exemption under Article 132(1)(c) and VATA 1994 Schedule 9 Group 7 Item 1. The First-tier Tribunal (FTT) emphasized that the taxpayer had the burden of establishing qualification for exemption. The FTT concluded that the services provided by the clinic did not qualify as medical care as they did not diagnose, treat, or cure health disorders, nor did they protect, maintain, or restore human health. The evidence showed that patients sought the clinic’s services to improve their appearance, without evidence of therapeutic benefit for health disorders. The FTT also addressed issues related to Botox treatments and the definition of purely cosmetic treatments.