VATHLT4040 - Blood and associated products: Storage of stem cells

Certain private companies operate private stem cells banks. Typically cells are collected at birth with a view to their possible future use for medical treatment of the child (‘autologous’ use) or of other persons (‘allogeneic’ or‘heterologous’ use). Contracts between the storage company and the child’s parent or parents usually ensure that the cells processed and stored are for medical use only; they are not available for research or experimentation.

The operations of a typical stem cell company were subject to an appeal to the European Courts of Justice in the case of Future Health Technology C-86/09 (FHT). Essentially FHT provided the following three services supervised by a health professional:

  • the dispatch of a kit for collecting blood from the umbilical cord
  • the testing and processing of that blood and,
  • the storage of stem cells contained in it (when appropriate).

FHT claimed that their supplies were exempt on the following grounds:

  1. they were a single composite supply of prophylactic (guarding from or preventing the spread or occurrence of disease or infection) medical care covered by the exemption under Article 132(1)(c) of the Principal VAT Directive, or
  2. they were a single composite supply of hospital or medical care or activities closely related thereto covered by the exemption under Article 132(1) (b), or
  3. alternatively, if their supplies were not a single composite transaction, the supplies of collection, testing, analysing, processing and cryopreserving (freezing at very low temperatures), as well as that of making the stem cells available in due course for therapeutic purposes, are each an exempt transaction within Article 132(1)(b) and (c)

The ECJ ruled that both Articles 132(1)(b) and(c) were both intended to cover services which “had as their purpose the diagnosis, treatment and, in so far as possible, cure of diseases or health disorders.” However, they decided that FHTs’ services did not fit this definition of medical or hospital care because “they are intended only to ensure that a particular resource will be available for medical treatment in the uncertain event that treatment becomes necessary but not, as such, to avert, avoid or prevent the occurrence of a health disorder, or to detect such a disorder in a latent or incipient state..” The Court did add that if FHT did actually use the stem cells to diagnose a specific illness, then this would be exempt medical care. The Court also ruled that services such as the collection and analysis of blood could not possibly be regarded to “closely related” to medical or hospital care when no actual medical care was being performed or envisaged.

The UK continues to view these supplies in the same way after leaving the EU.