Discussions are taking place to introduce an 18% VAT on aesthetic procedures, which could see a sharp increase in the cost of interventions like botox, varicose vein treatment or even teeth whitening. 

Times of Malta is informed that the Department of Inland Revenue is currently in discussions with the Medical Council to determine which services will be charged VAT.

When contacted, Saint James Hospital group director Maria Bugeja said the Inland Revenue Department has told service providers of aesthetic procedures and cosmetic surgeries that it intends to enforce the payment of VAT on a number of services. 

She said that VAT officers have been informing medical professionals to add 18% on their fees for so-called med-aesthetic services. 

“This is the first time that doctors and specialists in Malta will be adding VAT to their bills and services,” she said. 

It is understood that the imposition of VAT payment could see a sharp increase in the prices of a number of procedures, including the removal of warts and skin tags, treatments for pigmentation or acne scars, getting botox or fillers and even straightening out teeth with braces unless it is medically necessary. 

Malta has seen a dramatic increase in popularity of interventions mainly intended to improve a person’s appearance. But operators said the imposition of VAT on a number of procedures could prove to be a grey area, since they could be deemed essential for a person’s health or well-being. 

In a draft circular seen by Times of Malta, the department cites the VAT act to specify that the supply of medical care by a licensed healthcare professional should be VAT exempt, but the correspondence implies that it intends to be more reserved in what it considers to be medical care. 

"Malta has seen a dramatic increase in popularity of interventions mainly intended to improve a person’s appearance. But operators said the imposition of VAT on a number of procedures could prove to be a grey area, since they could be deemed essential for a person’s health or well-being"

According to the guidelines, the department will be considering any service that is meant to protect human health and the diagnosis, treatment and cure of diseases or health disorders in people, including mental health. 

“Supplies not primarily for the benefit of the patient shall not be considered as supplies of medical care,” the draft circular reads. Suppliers who spoke to Times of Malta have said that if VAT is imposed, most operators would have no choice but to raise their prices in response. 

“When we already have an exodus of Maltese people going to Turkey for cosmetic procedures, is this a wise measure to introduce at this time?” Bugeja asked. 

“We already struggle to keep our prices low to stay competitive with Turkey. This will be another blow to competitiveness.” 

Bugeja also said one should consider whether the price hike may increase the “not insignificant” number of people who require corrections in Malta after having a procedure done in Turkey. 

“If and when these corrections become necessary and if or when they need to happen as part of the provision of national healthcare, can we consider this a net gain or a net loss?” she asked. 

A professional who works in the field of aesthetic procedures who spoke to Times of Malta under condition of anonymity said that if implemented, it will likely see aesthetic clinics “haemorrhaging” patients to the Turkish market. “We estimate that some 60% of people in the market for aesthetic procedures already choose to go to Turkey. A price hike would impact a lot of people, some 18 to 20% of our business is botox and fillers for example.”

The source also expressed concern that a price hike would see an exodus of patients going to Turkey and indirectly increase the probability that complications arise from the cheaper procedures. 

Last year, Times of Malta reported how the phenomenon of ‘Turkey Teeth’ saw patients who travel overseas for cosmetic dentistry in agony after botched procedures, leaving local dentists to deal with the aftermath.

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