Value-added tax exemption for services performed by self-employed operating theatre assistant

It is compulsory for EU Member States by virtue of Value Added Tax Directive 2006 to exempt from value-added tax hospital nursing services and human medical care as well as closely associated duties. According to national Dutch legislation, value-added tax exemption applies to health care administered to human patients by medical or paramedical practitioners. The Individual Health Care Professions Act of the Netherlands (which in the Netherlands is referred to as the “BIG Act”) imposes standards on the specialist training these practitioners should have completed.

The Hague Court of Appeal in a recent ruling decided that the activities performed by a self-employed operating theatre assistant should be exempted from value-added tax. The fact that the practitioner in question performed his duties at his own risk rather than at that of the hospital where he worked meant that his situation was fundamentally different from that of similar operatives recruited by temping agencies. Remarkably enough the operating theatre assistant training programme does not come under the BIG regime, nor has the Dutch Minister of Health, Welfare and Sport imposed particular rules on said programme even though the present incumbent’s predecessor did substantively approve it at the time.