"BOOB TAX"

Over 90% of the procedures deemed ‘cosmetic’ are non-surgical treatments such as Botox, fillers and lasers. HMRC state that cosmetic services ‘performed mainly for beautification or rejuvenation purposes’ and ‘done out of free choice (elective) rather than medical necessity’ are liable for VAT. The British Association of Aesthetic Plastic Surgeons (BAAPS) agreed with caution this week with the Government’s decision that in the current climate they should be taxed with VAT.

Although BAAPS agree with the decision, they have warned that grouping surgery such as breast reductions, tummy tucks and children’s ear correction ops under this umbrella term will present an ethical minefield. BAAPS have called for a debate with the relevant bodies and a halt on this initiative which could breach patient confidentiality by providing an audit trail for HMRC to verify if a procedure is exempt or not breaches doctor patient confidentiality and the Data Protection Act and encourage risky ‘surgery in the sun’ deals abroad.

According to the guidance to health professions by the HMRC, services are only exempt from VAT if the purpose is to ‘protect, maintain or restore the health of the person concerned’. BAAPS has argued this week that this will leave a value judgment on treatment, and fails to recognize the extensive scope and purpose of most plastic surgery procedures. It 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. Many aesthetic procedures were performed on the NHS for psychological reasons, although they are no longer offered. So clearly they were considered medical before.

President of BAAPS and Consultant Plastic Surgeon, Fazel Fatah explained: “The reasons for undertaking aesthetic plastic surgery vary widely and from patient to patient – the same condition can affect each person in a different way. Some may experience side effects, others it can affect their ability to work, or they could suffer serious psychological impact. It is simply not possible to generalise about the reasons for treatment.”

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