The cost of facelifts, tummy tucks, liposuction and breast enlargements in the UK is set to rise by 20% after new government guidelines on Value Added Tax. Doctors performing purely cosmetic operations must register for VAT and pass the charge on to patients in a move that will boost public finances. According to the British Association of Aesthetic Plastic Surgeons (BAAPS), cosmetic surgeons in the UK in 2010 carried out 9,430 breast enlargements, 3,417 tummy tucks, 5,000 facelifts, more than 4,000 nose jobs and over 1,000 operations to correct ears that stick out. At the moment, a breast enlargement operation can cost up to £5,000, which will rise to £6,000 once VAT is added. The average cost of a facelift could rise from about £6,000 to £7,200.
HM Revenue and Customs (HMRC) argues it is only clarifying existing laws in guidance sent to trade professionals and that there is no change in government policy on VAT for cosmetic surgery; VAT is not charged on surgery for medical reasons. 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’.
BAAPS says that over 90% of procedures deemed cosmetic are non-surgical treatments such as injectables and lasers, and it agrees they should be taxed with VAT. However, they warn that including surgery such as breast reductions and tummy tucks will present an ethical minefield.
Fazel Fatah of BAAPS warns, “Using blanket terminology such as ‘free choice rather than medical necessity’ and ‘purely for aesthetic purposes’ places a value judgment on treatment and compromises the doctor-patient relationship. Treatments carried out by cosmetic surgeons do improve the psychological as well as the physical wellbeing of patients. The subjective proposals by HMRC will potentially harm large numbers of patients. They imply that any procedure that corrects appearance rather than function is not a medical need. With surgery, we are quite literally, dealing with human lives.”
Dr Samantha Gammell of the British Association of Cosmetic Doctors adds, ’When patients seek out care from doctors they expect to be treated without judgment or prejudice, putting the maintenance of their health as our primary concern. We are appalled that HMRC inspectors are demanding to review confidential patient records for proof of their medical needs. It is an obscene invasion of privacy based on a ridiculous premise that a doctor, having taken on a duty of care, could do otherwise than protect the health of their patient. There is simply no legal basis for the HMRC’s approach and we will continue to fight for patients’ rights.”
In 2009, in the USA, the authorities had the idea of charging a 5% tax on all cosmetic procedures. It failed to get through the Senate. The UK situation is different as it is not a planned legislative change but a change of interpretation by HMRC who act independently of politicians.
A number of people already travel abroad for cosmetic surgery, as it is cheaper in Eastern and Central Europe. Although it is even cheaper in parts of Asia, few travel that far for simple cosmetic work. UK cosmetic surgery associations have warned that patients ”unable to afford elevated prices in the UK, will be forced to travel abroad where standards and guidelines for cosmetic surgery are not necessarily as strictly controlled.”
If you are prepared to travel for cosmetic surgery abroad, with clinics everywhere from Brazil and Bulgaria to Thailand and Tunisia seeking UK clients, you can certainly get a much cheaper deal. In many places, the standards of surgery are as good as the unregulated UK cosmetic surgery industry.
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