
Bo-Tax is fine, argue surgeons, but ‘subjective’ VAT on surgery is an ethical minefield
Over 90% of procedures deemed ‘cosmetic’ are non-surgical treatments such as injectables and lasers, and the British Association of Aesthetic Plastic Surgeons (www.baaps.org.uk) agrees with the Government’s decision due out this month that in the current climate they should be taxed with VAT. However, they warn that bundling surgery such as breast reductions, tummy tucks and children’s bat-ear ops under this umbrella term will present an ethical minefield. They call for a debate with the relevant bodies and a halt on this initiative which endangers patient confidentiality, leaves the public vulnerable to arbitrary postcode lotteries and will encourage risky ‘surgery holiday deals’ abroad.
HMRC guidance to health professions states that services are only exempt of VAT if the purpose is to ‘protect, maintain or restore the health of the person concerned’. The BAAPS argues this subjective approach places a value judgment on treatment, fails to recognize the extensive scope and purpose of most plastic surgery procedures and does not provide enough clarification in terms of medical, psychological and social welfare of the patient. It will also require general finance/accounting and audit staff – unqualified to determine what could be ‘medical’ need – to have access to patient records in order to validate criteria.