GST issues registers

Health industry partnership

Issue 2 - Other health services

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(a) added, (u) updated, (w) withdrawn

2.a. Section 38-10 Other health services

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Related questions

The following questions explore what is within the concept of 'other health services' for the purposes of section 38-10. None of the questions and answers should be read in isolation but rather as part of the whole of the information contained in this document.

2.a.1. Are the services of psychotherapists and psychoanalysts GST-free?

2.a.2. Is the service of a hypnotherapist GST-free?

2.a.3. Item 8 in the Table of section 38-10(1) lists the service of Herbal Medicine (including traditional Chinese herbal medicine). Ayurvedic medicine has gained popularity in Australia over the last decade. Professional training courses are now being conducted in Ayurvedic medicine and there is a national professional association that accredits Ayurvedic medicine practitioners. Ayurvedic medicine is essentially understood by both the layperson and health professionals as being the practice of herbal medicine in India. What is the ATO's interpretation of Item 8 regarding Ayurvedic medicine?

Non-interpretative - straight application of the law.

Assuming the above information is correct, provided the application of Ayurvedic medicine is generally accepted as appropriate treatment by *recognised professionals of 'Herbal medicine', the supply will be GST-free provided that the other elements of section 38-10(1) are satisfied. As described, it would appear Ayurvedic medicine is a technique of herbal medicine.

2.a.4. Naturopathy and Herbal Medicine are services listed in the Table in section 38-10(1) items 8 and 9. The practice of naturopathy and herbal medicine includes iridology as a diagnostic technique, which is generally accepted in naturopathy and herbal medicine as being for appropriate treatment. A naturopath and herbalist for the purpose of preserving, restoring or improving the physiological wellbeing of a patient would use iridology. Does the ATO agree that iridology performed by a naturopath or herbalist would be GST-free?

Non-interpretative - straight application of the law.

Based on the above facts if iridology is a diagnostic technique of 'Naturopathy' and 'Herbal medicine', it will beof a service of a kind within section 38-10(1)(a). The service will be GST-free if:

a.

it is generally accepted by *recognised professionals in 'Naturopathy' and 'Herbal medicine' that iridology is necessary for the appropriate treatment of the recipient of the supply, and

b.

the *recognised professional supplies either Naturopathy or Herbal Medicine services and is skilled in its application.

2.a.5. What is the GST treatment of pathology requested by a naturopath to be undertaken by an *approved pathology practitioner?

For source of ATO view, refer to Part 3 of GSTR 2006/9 - Goods and services tax: supplies.

The provision of pathology examinations and consequent results may be GST-free under section 38-7 if done by an *approved pathology practitioner and all of the remaining elements of section 38-7 are met. This supply is identified as a separate supply from any supply made by the other health professional who may be a *recognised professional under section 38-10.

In relation to pathology, it is acknowledged that other health professionals sometimes make requests and the results are provided to the other health professionals. However, it is considered that the supply is not at the direction of or as a requirement of the other health professional. The patient can choose whether or not to attend for the pathology service and the patient can request that the results be provided to another health professional to benefit the patient in relation to other treatments.

It is assumed for this answer that the patient is primarily liable for the payment of the supply and the results will be considered and reported on by an *approved pathology practitioner. As such, it is considered that the recipient of the supply is the patient.

2.a.6. What type of recognised professional provides a service of 'Dietary' listed at Item 7 of the Table?

Non-interpretative - straight application of the law.

It is considered that dieticians and nutritionists would in certain circumstances be providing dietary services. From information supplied to the ATO it is understood there is only one professional association that may have uniform national registration for the purposes of paragraph (b) of the definition of *recognised professional in section 195-1. This association is the Dieticians Association of Australia.

2.a.7. Paragraph (b) of the definition of *recognised professional provides that a person is a recognised professional where 'the service is supplied in a state or territory in which there is no state law or territory law requiring such permission, approval or registration, and the person is a member of a professional association that has uniform national registration requirements relating to the supply of services of that kind'. What is the ATO's interpretation of '… a professional association that has uniform national registration requirements …'?

Non-interpretative - straight application of the law.

These words are not defined in the GST Act and will have their ordinary meaning. If a particular association wants confirmation of its status a specific ruling may be sought from the ATO.

A number of professional associations have been identified in relation to the supply of services of the kinds listed in the Table in section 38-10(1). These professional associations often require a person to a have a minimum level of educational qualifications (usually tertiary level qualifications) before that person will satisfy the association's requirements for practitioner status. These professional associations are national associations and the registration requirements for practitioner status are the same for all practitioners regardless of the state or territory in which they practice.

2.a.8. Some allied health practitioners employ assistants to provide certain services to patients. These employees are not 'recognised professionals' to provide a service of a kind listed in the Table and they may not legally be required to be registered or licensed, and may not be members of a National Association. The services are provided at the direction of the 'recognised professional', and would be generally regarded by the profession as appropriate for the treatment of the recipient. Will the service by the assistant be GST-free under section 38-10?

For source of ATO view, refer to issue 2.a of this issues register.

Section 38-10(1)(b) requires that the supplier of the service for the purposes of section 38-10 be a recognised professional. If a component of the supply is not provided by a 'recognised professional' it will be a taxable supply unless that assistant is directly supervised in undertaking that component.

It is considered that a person will be directly supervised where the *recognised professional:

a.

attends the patient at the commencement of the treatment and at the subsequent commencement of each new treatment, and

b.

is readily available for the whole of the time that the assistant is working with the patient, and

c.

that the *recognised professional be available to take appropriate action in the case of an emergency, and

d.

determines all of the appropriate treatment to be provided by the assisting person, and

e.

can satisfactorily prove that they monitor the services of the unqualified staff.

2.a.9. Is massage therapy GST-free?

Non-interpretative - straight application of the law.

The question requires a consideration of sections 38-7 and 38-10.

Massage therapy may be GST-free if supplied by a *medical practitioner pursuant to section 38-7 provided all the elements of that section are satisfied (see Issue 1.a.9 of this document) and the practitioner is skilled in the provision of that service.

As to whether massage therapy by other health professionals will be GST-free initially depends on whether the treatment is within a service of a kind specified in the Table at section 38-10(1). Those services in the Table which may include massage therapy as being the entire supply is 'Physiotherapy' and those which may include massage therapy as a component of the overall supply include 'Acupuncture', 'Chiropractic', 'Nursing', 'Occupational therapy', 'Osteopathy', 'Naturopathy' and 'Physiotherapy'.

In order to be GST-free, all of the elements of section 38-10 must be satisfied. In particular the supply must generally be accepted in the profession associated with the service as being necessary for the appropriate treatment of that particular patient by that recognised professional (bearing in mind their training in providing massage therapy).

In order for massage therapy per se to be added to the Table, a Regulation would need to issue and no such regulation is intended at this point in time.

2.a.10. Where an entity (company, trust or partnership) provides massage therapy services and the individual massage therapists who are subcontracted to that entity are not registered or required to registered for GST, does the practice have to charge GST on services provided by the massage therapists?

For source of ATO view, refer to:

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Part 3 of GSTR 2006/9 - Goods and services tax: supplies

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Issue 2.a and Issue 2.a.11 of this issues register

This question examines supplies made by an entity where the supply would not be subject to GST if supplied by the individual massage therapist because the individual is not registered, or required to be registered, for GST. Whilst this question is in relation to massage therapists, it is relevant to all supplies by an entity where section 38-10 is to be considered.

Where the elements of section 9-5 are satisfied (it is assumed for the purposes of this question that they are) and the supply is not GST-free or input taxed, the supply will be a taxable supply.

In considering the question it is necessary to identify the relevant supply.

In this question there are two supplies:

1.

a supply by the entity to the patient

2.

a supply by the individual massage therapist to the entity.

In relation to the first supply:

In many cases, the entity itself will not be able to satisfy the requirements of section 38-10(1)(b) to be a recognised professional.

For the purposes of the application of section 38-10(1)(b), it is considered that the focus is not whether the entity itself is a recognised professional. It is considered that the relevant issue to be determined is whether the performer of the service is a recognised professional in respect of one of the listed services (see Issue 2.a.11) or, where the performer is not the relevant recognised professional, the performer is directly supervised by the relevant recognised professional (see Issue 2 - Meaning of 'the supplier is a recognised professional' and Issue 2.a.8). It is also necessary that the supply is of one of those listed services and that the supply is generally accepted in the relevant profession as being necessary for the appropriate treatment of the recipient of the supply (refer to discussion under Issue 2 and as to whether massage therapy is GST-free to answer at Issue 2.a.9 ). Where all the necessary requirements of s38-10 are satisfied, the supply by the entity will be GST-free.

If these requirements are not satisfied, the supply by the entity will not be GST-free.

In relation to the second supply, it will not be GST-free. However if the therapist is not registered or required to be registered the supply will not be a taxable supply.

2.a.11. Section 38-10(1)(b) of the GST Act requires that the supplier of other health services be a recognised professional. In many instances the supplier of the service is a practice company or partnership which is not itself a recognised professional. Will GST apply in this scenario?

2.a.12. Does Item 6 'Dental' in section 38-10(1)(c) include orthodontics?

Non-interpretative - straight application of the law.

Supply of an orthodontic service to a patient will be GST-free as it is considered to be 'Dental'which appears at Item 6 in section 38-10(1). The Macquarie Dictionary, third edition, defines 'orthodontics' as 'the branch of dentistry that is concerned with the correction of irregularities of the teeth or jaw'. It will also be necessary for the supplier of the orthodontic service to be a *recognised professional for the purposes of section 38-10. It is understood that the practise of dentistry is regulated at the state level. If the supplier conforms with the state or territory laws they will be a *recognised professional as that term is defined in section 195-1.

As a final requirement the supply of the orthodontic service must be generally accepted in the dental profession as being necessary for the appropriate treatment of the patient.

For further information refer to CR 2013/14 - Goods and services tax: goods and services supplied by dentists.

The supply of orthodontic appliances in the course of supply a GST-free dental service is considered at Issue 2.b.3.

2.a.13 What is the GST status of health services provided to more than one person at the same time?

2.a.14. What is the GST status of ergonomic and risk assessments for workers/employees requested by employers?

For source of ATO view, refer to Part 3 of GSTR 2006/9 -Goods and services tax: supplies.

The supply will not be GST-free where an employer requests ergonomic and risk assessments of a general workplace as the supply will not constitute 'appropriate treatment'. Further, the recipient of the supply will be the employer. The employer may be entitled to an input tax credit.

Section 38-60 will not apply in these circumstances as there is no appropriate treatment of an individual which would be GST-free under Subdivision 38-B. Refer to Issue 1.a.6 for a further explanation of section 38-60. Where an individual, concerned with the ergonomics or risk associated with their work environment, requests a recognised professional to identify and advise of corrections to the workplace for that individual to prevent illness or disability, it is accepted that this may be appropriate treatment where all the other elements of section 38-10(1) are satisfied.

In limited circumstances this may be paid for by an insurer, operator of a statutory compensation or compulsory third party scheme or an Australian government agency under a multi-party arrangement. The recognised professional may be making a GST-free supply to the insurer, operator or agency in these circumstances under section 38-60 - see issue 1.a.6. Such assessments would need to be undertaken by a *recognised professional for the service of 'Occupational therapy' (Item 11 of Table) or 'Physiotherapy' (Item 17 of Table). In order for the assessment to be considered 'necessary for the appropriate treatment of the recipient of the supply', the *recognised professional would have to have assessed the recipient's state of health and determined the ergonomic and risk assessment in an attempt to preserve, restore or improve the physical or psychological wellbeing of a particular patient.

2.a.15. Are denture repairs or relines GST-free?

2.a.17. Where a patient is referred to a dentist by an ENT surgeon in order to fabricate and fit ear plugs to be worn in association with grommets, is this service GST-free?

For source of ATO view, refer to:

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CR 2013/14 - Goods and services tax: goods and services supplied by dentists

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Issue 2.a of this issues register.

Yes, the fitting of ear plugs by a 'recognised professional' for 'Dental' services will be GST-free provided the supply would generally be accepted in the dental profession as being necessary for the appropriate treatment of the patient. Acting in accordance with a referral from a specialist surgeon is evidence that the service would be likely to be accepted as 'appropriate treatment' within the profession.

The supply of the ear plugs will be GST-free pursuant to section 38-10(3) as being goods supplied 'in the course of', provided they are supplied at the same point in time as the clinical service and have been customised or manipulated for the exclusive treatment of the patients ear condition.

For detailed information as to the meaning of 'in the course of supplying' see further in Issue 2.b.

2.a.18 Where a patient has abnormal staining of the teeth and the dentist arranges for the making of a customised resin tray to apply bleaching material, will the fitting and fabrication be a GST-free dental service? The tray may be prescribed to be worn at home with supplied medicaments and the treatment is monitored by follow-up appointments.

For source of ATO view, refer to:

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CR 2013/14 - Goods and services tax: goods and services supplied by dentists

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Issue 2.a of this issues register.

Yes, the fitting of a customised resin tray by a 'recognised professional' for 'Dental' services will be GST-free provided the supply would generally be accepted as being appropriate treatment of the patient. It is considered that such treatment of teeth, where there is abnormal staining would in a large number of cases be generally accepted in the dental profession as being necessary for the appropriate treatment of the recipient of the supply.

The supply of the customised resin tray at the time of the supply of the GST-free dental service will also be GST-free to the patient as being goods supplied 'in the course of' pursuant to section 38-10(3).

For more information as to the meaning of in the course of supplying, see Issue 2.b.

2.a.19 Would the supply of a dental service of bleaching of teeth be GST-free if a patient had teeth in the normal range of colour prior to the process?

For source of ATO view, refer to:

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CR 2013/14 - Goods and services tax: goods and services supplied by dentists

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Issue 2.a of this issues register.

The bleaching of the teeth of a patient where the whole of their teeth colour is already in the normal range of colour and which is then being undertaken for purely cosmetic reasons should not in the majority of cases be GST-free. It is considered unlikely that such a supply would generally be accepted in the dental profession as being necessary for the appropriate treatment of the recipient of the supply.

2.a.20 Where travel is undertaken by a health service provider as part of the supply of a GST-free medical or other health service and the practitioner charges the patient a higher fee because of the requirement to travel to another place for that treatment, will the additional amount be GST-free?

Non-interpretative - straight application of the law.

Where the practitioner is required to travel to the premises of a client and it is an integral component of the appropriate treatment that the service is to be performed at those premises, any additional charge for the reason that the practitioner is required to perform those services at those premises will be embodied in the supply of that service being a medical or other health service. Accordingly the additional amount will be GST-free provided all of the other necessary elements of sections 38-7 or 38-10 are met.

An example of where travelling to a patient's premises will be part of the appropriate treatment is where a patient is immobilised due to back injury and a 'recognised professional' in 'physiotherapy' travels to the patients residence to provide the appropriate treatment.

Another example is where an occupational therapist travels to a patient's employment premises to consider and advise upon the physical work environment of the patient as part of the appropriate treatment of the patient.

Where the practitioner undertakes travel to provide the treatment as a matter of convenience, then that component of the supply is not GST-free. Section 9-80 is applicable as it relates to 'The value of taxable supplies that are partly GST-free or input taxed'.

2.b. Goods supplied 'in the course of supplying' a GST-free 'other health service'.

For source of ATO view, refer to issue 1.c of this issues register.

Section 38-10(3) provides that the supply of goods will be GST-free if:

a.

It is made to a person in the course of supplying to the person a service the supply of which is GST-free under subsection (1) (other than a service referred to in item 8, 9, 12 or 15 of the table in subsection (1)), and

b.

it is made at the premises at which the service is supplied.

The services excluded from this provision which are referred to in item 8, 9, 12 and 15 are 'Herbal medicine (including traditional Chinese herbal medicine)', 'Naturopathy', 'Optometry' and 'Pharmacy'.

Section 38-10(4) provides that a supply of goods will be GST-free if:

a.

it is made to a person in the course of supplying to the person a service referred to in item 8 or 9 of the table in subsection (1), and

b.

it is supplied, and used or consumed, at the premises at which the service is supplied.

The services included in this provision are 'Herbal medicine (including traditional Chinese herbal medicine)' and 'Naturopathy'.

The phrase 'in the course of supplying to the person a service' in the context of section 38-10(3) and 38-10(4) is interpreted to require that the goods are supplied at the same point in time at which the identified GST-free 'other health service' is supplied. These identified GST-free 'other health services' are for section 38-10(3) (that is items 1-7, 10, 11, 13, 14, and 16-21 of the Table in section 38-10), and for section 38-10(4) - 'Herbal medicine (including traditional Chinese herbal medicine)' and 'Naturopathy'.

In addition the goods will have to have been either:

a.

customised or manipulated for the exclusive treatment of the illness or disability of the particular patient who is the recipient of the GST-free 'other health service', or

b.

necessarily utilised as an integral part of the patient's treatment required immediately during that specific consultation.

As stated for section 38-10(4), additionally the goods must be 'used or consumed' at the premises as described below in Issue 2.c.

'In the course of supplying', as the phrase appears in section 38-10(3) and section 38-10(4), has the same meaning as in section 38-7(3). However, section 38-10(4) has an additional requirement that the goods supplied must also be 'used or consumed, at the premises at which the service has been supplied'.

Related questions

The following questions explore what is within the concept of goods supplied 'in the course of supplying' an 'other health service', for the purposes of section 38-10. None of the questions and answers should be read in isolation but rather as part of the whole of the information contained in this document.

2.b.1. Where an attendance takes place at a client's premises, will any goods supplied at that time be GST-free?

For source of ATO view, refer to issue 1.c of this issues register

Yes, goods will be GST-free if they are supplied at the premises at which the GST-free 'other health service' is supplied, which may in certain instances take place at the patients premises.

Additionally, in order to be GST-free the goods must be supplied at the same point in time at which the GST-free 'other health service' is supplied and the goods must have been either:

a.

customised or manipulated for the exclusive treatment of the illness or disability of the particular patient who is the recipient of the GST-free 'other health service', or

b.

necessarily utilised as an integral part of the patient's treatment required immediately during that specific attendance.

For section 38-10(4), additionally the goods must be 'used or consumed' at the premises as described below in Issue 2.c.

2.b.2. A recognised professional prescribes and dispenses vitamins and herbs for a condition. Will these goods supplied at that time be GST-free?

For source of ATO view, refer to issue 1.c of this issues register.

If the vitamins and herbs are customised or manipulated for the exclusive treatment of the illness or disability of the particular patient who is the recipient of the GST-free other health service they may be GST-free. They would also have to be dispensed by a *recognised professional (as defined) in relation to the supply of services of the following to be GST-free under section 38-10(3):

Finally the supply will have to be made at the same point in time as the GST-free other health service and made at the premises at which that service is supplied.

For the goods supplied by a *recognised professional of 'Herbal medicine (including traditional Chinese herbal medicine)' and 'Naturopathy' to be GST-free the supply would need to meet the elements outlined for section 38-10(3) and only the portion used or consumed at the premises where the service is provided (in accordance with the interpretation given in Issue 2.c. below) will be GST-free.

2.b.3. A recognised professional fits a patient with an appliance for the purpose of correcting an illness or disability. Will these goods supplied at that time be GST-free?

For source of ATO view, refer to issues 1.c together with 2.a of this issues register.

This question requires the consideration of sections 38-45 and 38-10 and focuses upon the supply of goods.

The goods may be GST-free pursuant to section 38-45 if they are:

a.

a medical aid or appliance covered by Schedule 3 or subsequent regulation, and

b.

the medical aid or appliance is specifically designed for people with an illness or disability, and

c.

the medical aid or appliance is not widely used by people without an illness or disability.

Once an item meets all of the above criteria its supply will be GST-free. The GST-free status will apply all the way down the supply chain and not only when supplied to a person who has an illness or disability. The elements do not require the recipient of the aid or appliance to use it in a particular way. An example of medical aids and appliances that are contained in Schedule 3 are heart monitors and pacemakers (Items 1 and 2 of Schedule 3).

If section 38-45 does not apply to the goods it is necessary to consider the application of section 38-10(3) which may allow the goods to be GST-free if they are supplied at the premises at which the identified GST-free other health service is supplied by a *recognised professional. Additionally, the goods must be supplied at the same point in time at which the GST-free other health service is supplied and the goods must have been either:

a.

customised or manipulated for the exclusive treatment of the illness or disability of the particular patient who is the recipient of the GST-free 'other health service', or

b.

necessarily utilised as an integral part of the patient's treatment required immediately during that specific consultation.

2.b.4. A person is qualified as a recognised professional in both Acupuncture and Naturopathy (or Chinese herbal medicine). The patient is treated with a range of approaches, sometimes involving the use of acupuncture and sometimes not. A herbal formulae is usually customised and dispensed at each treatment. Herbal medicine is part of the scope of practice of acupuncture, but this practitioner has further skills and is recognised in their own right as a herbalist/naturopath as well. Is the herbal formulae always GST-free by virtue of the recognised professional being an acupuncturist?

2.b.5 Are customised mouthguards taxable?

Non-interpretative - straight application of the law.

Yes, customised mouthguards are a taxable supply. They can not become GST-free as being supplied in the course of a GST-free health service by a recognised professional supplying 'dental' services. Although they have been 'customised' or 'manipulated' they are not related to an 'exclusive treatment of an illness or disability'. Additionally, the ATO's interpretation of 'in the course of supplying' will not render customised mouthguards GST-free as they would not be 'required immediately' but rather are supplied subsequent for use.

For further information refer to paragraph 42 of CR 2013/14 - Goods and services tax: goods and services supplied by dentists.

2.b.6 A practitioner has been advised by a herbal company that the raw herbs she uses are really foods just like nuts and are GST-free. Raw herbs are described as herbs that have not been processed in a factory but have usually been dried. They may consist of leaves, bark, twigs, roots, flowers, seeds, fruit. Some commonly used medicinal herbs include ginger, cinnamon, cardamom, turmeric, licorice. In the case of Chinese herbal medicines it can also extend to some minerals such as calcium based products (for example ground oyster shell) and animal products.

Will raw herbs be considered as food and treated as GST-free, or recognised as herbal medicines and attract the GST?

Non-interpretative - straight application of the law.

Raw herbs supplied by a medical practitioner or a recognised professional may be GST-free pursuant to sections 38-7(3), 38-10(3) or 38-10(4) as being goods supplied in the course of a GST-free medical service or other health service. For the necessary requirements of those sections, see Issues 1.c., 2.b. and 2.c.

As to the applicability of the Food provisions in Subdivision 38-A, a significant issue is that raw herbs which are supplied as part of a herbal formula/prescription are not GST-free under the food provisions. The reason for this is that the character of the individual items have changed character once mixed.

It remains then to consider whether the supply of raw herbs separately as a food, will be GST-free under the Food provisions.

Raw herbs will be GST-free as food where the requirements of section 38-2 of the GST Act are satisfied. Where raw herbs do not satisfy the requirements of section 38-2, they will not generally be GST-free.

Section 38-2 states:

'A supply of *food is GST-free.'

'Food' is defined in section 38-4 as being any one, or a combination of, the following:

a.

food for human consumption (whether or not requiring processing or treatment)

b.

ingredients for food for human consumption

c.

*beverages for human consumption

d.

ingredients for beverages for human consumption

e.

goods to be mixed with or added to food for human consumption (including condiments, spices, seasonings, sweetening agents or flavourings)

f.

fats and oils marketed for culinary purposes

but does not include:

a.

live animals (other than crustaceans or molluscs)

b.

unprocessed cow's milk

c.

any grain, cereal or sugar cane that has not been subject to any process or treatment resulting in an alteration of its form, nature or condition, or

d.

plants under cultivation that can be consumed (without being subject to further process or treatment) as food for human consumption.

Separately supplied raw herbs may be GST-free as food, provided the herbs are not supplied in the form of a living plant. They are possibly GST-free as food as either:

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food for human consumption

•

ingredients for food for human consumption, or

•

goods to be mixed with or added to food for human consumption.

Food is not further defined and will take on its ordinary meaning. The Macquarie dictionary defines 'food' as:

'what is eaten, or taken into the body, for nourishment'.

The courts, in determining whether a particular good is food, will look to what an ordinary person understands food to be. It is considered that a good will generally be food where it has the normal characteristics of food in that it looks like food, tastes like food and fills the stomach like food.

Many of the goods mentioned in the question, such as ground oyster shell and many leaves, bark, twigs, roots, flowers and seeds, do not have the normal characteristics of food and will not be food and would not generally be considered to be ingredients of food.

It should be noted that 'goods to be mixed with or added to food' whilst only including spices, condiments, seasonings also may include commercial additives such as chemicals that are used only for food purposes.

Some of the things listed in the question would satisfy the definition. This includes ginger, cinnamon, cardamom, turmeric and licorice. Generally, these are all either ingredients or they satisfy 'goods to be mixed with or added to food'. However, it will be necessary for the goods to be in a form that will satisfy the requirements. For example, goods in tablet or capsule form or goods which have been added to other goods such that they lose their identity as 'food' will not satisfy the requirements. Also as stated above if provided as part of a herbal formula/prescription the raw herbs will not be GST-free under the Food provisions.

2.c. Additional requirement for goods supplied 'in the course of supplying' a GST-free 'other health service' (herbal medicine and naturopathy only)

Related questions

The following questions explore what is within the concept of whether goods are 'supplied, and used or consumed, at the premises at which the service has been supplied' for the purposes of section 38-10(4). None of the questions and answers should be read in isolation but rather as part of the whole of the information contained in this document.

2.c.1. What is the GST status for goods supplied by herbalists and naturopaths, which are for consumption off the premises or are only partially consumed on the premises at the time of treatment?

For source of ATO view, refer to issue 2.c of this issues register.

In accordance with section 38-10(4), the goods supplied must be completely used or consumed at the premises at which the service is supplied. If a supply of goods is used or consumed at a place other than the premises where the GST-free service is supplied then section 38-10(4) will not be satisfied. If the goods are only partially consumed, the goods have not been 'used or consumed at the premises' and only that portion consumed at the premiseswill be GST-free in accordance with section 38-10(4).

2.c.2. Where a herbalist or naturopath explains the constituents of a herbal mixture, discuss possible side effects and demonstrate how to take herbs, have the goods been 'used' in the course of supplying a GST-free service?

For source of ATO view, refer to issue 2.c of this issues register.

No, the goods must be wholly 'used or consumed' at the premisesat which the supply of the service is made. Explanation, demonstration and discussion will not constitute 'used or consumed'. Only the portion of the herbal mixture supplied 'in the course of supplying' the GST-free service that is completely consumed or ingested during that service, be GST-free.

2.d. Supplies 'provided by an ambulance service in the course of the treatment of the *recipient of the supply'.

Non-interpretative - straight application of the law.

Ambulance services are GST-free pursuant to section 38-10(5). The section provides that 'a supply is GST-free if it is provided by an ambulance service in the course of the treatment of the *recipient of the supply'. Also refer to GSTR 2006/9 - Goods and services tax: supplies, for the ATO view on determining who is the recipient of the supply.

Related questions

The following questions explore what is within the concept of supplies 'provided by an ambulance service in the course of the treatment of the *recipient of the supply'. None of the questions and answers should be read in isolation but rather as part of the whole of the information contained in this document.

2.d.1. Is non-emergency transport by an ambulance service GST-free if it is for the transport of people between their homes and places of medical treatment?

Non-interpretative - straight application of the law.

A supply of transport by an ambulance service is only GST-free where it is supplied in the course of the treatment of the recipient of the supply. It is considered that transport by an ambulance service from home to a place for treatment is not dissociable to the course of treatment and is GST-free.

2.d.2. Is transportation by a taxi service GST-free if it is for the transport of people between their homes and places of medical treatment?

Non-interpretative - straight application of the law.

No. A supply of transportation by a taxi operator is not a supply by an ambulance service.

2.d.4. Are ambulance subscriptions GST-free?

Non-interpretative - straight application of the law.

Section 38-55(2) provides 'A supply of insurance against liability to pay for services supplied by ambulance is GST-free'. This will include ambulance subscriptions.

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