Fees are not exempt

D Ltd a subsidiary of AXA PPP Healthcare Group plc provided administrative and support services to dentists. In a contract between the dentist and the patient the latter paid D a fixed monthly sum in return for a specified amount of dental care. D acted as agent for the dentist in receiving the payments which it forwarded to the dentist charging a small fee in consideration of its services.

AXA claimed that part of the fee was VAT exempt by virtue of Article 13(B)(d)(3) of the Sixth Directive as implemented by VATA 1994 Sch 9 group 5. HMRC disagreed saying that the fees charged to dentists were consideration for supplies of services subject to VAT. AXA appealed.

The appeals proceeded through the courts to Court of Appeal which referred to the European Court of Justice for...