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HMRC internal manual

VAT Health

The services of the medical and paramedical professions: opticians: hospital optical dispensing

We do not accept that an optician who happens to operate from a hospital premises can make wholly exempt supplies of spectacles or contact lenses under item 4 of Group 7 - although his supplies of services are of course exempt in their own right under item 1(b). Item 4 allows exemption for the provision of care or medical or surgical treatment by a hospital and since opticians do not provide this, the goods that they dispense cannot benefit from that exemption. This view is supported by the following Tribunal:

Coleman (VTD 10512) concerned a hearing aid dispenser who operated from a hospital, but was not part of that hospital. The Tribunal found that Mr Coleman’s activities were not ‘the provision of care or medical or surgical treatment’ and that his supplies of goods could not therefore, be exempted under item 4. His appeal was therefore dismissed and he was required to account for VAT on his supplies of hearing aids. The principles established by this decision can be applied equally to opticians, or indeed to any other professional wishing to claim exemption for goods solely because of their geographical location.

We do accept however, that in specialist eye hospitals, any optical goods supplied to patients are incidental to that hospital’s supply of medical care to its patients and are thus exempt under item 4 as goods ‘in connection with’. This is because these patients usually have complex medical problems with their eyes and do not require the services of a ‘normal’ high street optician.

VATHLT3000 deals with this area in more depth.