Dr Mohit Bhandari, a bariatric surgeon from Indore, had appealed against the service tax imposed on him, saying bariatric surgery was a life-saving procedure.
The Larger Bench of the Customs Excise and Service Tax Appellate Tribunal (CESTAT), Delhi, ruled on Wednesday that service tax cannot be imposed on bariatric surgery as it is a life-saving procedure and not a cosmetic one. The tribunal stated that bariatric surgery is for people who have health issues such as type-2 diabetes, hypertension, sleep apnea and coronary artery disease, which stem from their excess weight, and is different from weight-loss procedures such as liposuction.
The order was passed after Dr Mohit Bhandari, a bariatric surgeon who runs Mohak Hitech Speciality Hospital in Indore, moved the tribunal in 2015 against the service tax levied on him under the Finance Act. Dr Bhandari was one of 15 bariatric surgeons, including some from Mumbai, who had lodged appeals in the tribunals in Delhi and Mumbai for relief from the service tax imposed on them.
As part of his appeal, Dr Bhandari had presented various studies conducted in India and abroad that show how cosmetic surgery and weight-loss surgery are two different procedures. One study conducted in Cleveland suggested that weight-loss surgery resulted in a resolution of type-2 diabetes in 95 per cent of patients, obstructive sleep apnea in 98 per cent, joint pains in 80 per cent, and lipid disorders in 96 per cent.
He told Mirror, “Obesity is a disease. We have the lives of so many patients change after they undergo bariatric surgery. Apart from losing weight, many of their comorbidities associated with obesity disappear. This shows that bariatric surgery is used to treat obesity and associated medical ailments, and is not cosmetic surgery. Those who undergo the procedure suffer from lifethreatening diseases. Many are not even able to walk. Most of these patients have other problems related to obesity too, such as type-2 diabetes, hypertension, arthritis, lipid disorders and obstructive sleep apnea.”
(L) Dr Mohit Bhandari; Eman Ahmed, an Egyptian national and the world’s heaviest woman, had undergone bariatric surgery in Mumbai in April 2017. She passed away in Abu Dhabi in September that year
He added, “A person selected for this surgery should also have a body mass index of above 32.5 with co-morbidities. The surgery is performed as per guidelines issued by the Asia Pacific Chapter of the International Federation for the Surgery of Obesity and Metabolic Disorders, which are endorsed by Obesity Surgery Society of India. I did not pay service tax because I am saving the lives of my patients.”
The tribunal observed that bariatric surgery is a procedure through which the food intake capacity of the patient is restricted, resulting in weight loss for control of obesity-related diseases. It also observed that other weight-loss procedures such as liposuction only involve removing excess fat from specific target areas to improve the shape of the body.
“The appellant, therefore, contends that bariatric surgery is clearly distinguishable from plastic or cosmetic surgery inasmuch as it is intended to reduce the weight of an excessively obese person and thus, the treatment and prevention of various diseases… whereas plastic or cosmetic surgery is intended to improve the outer shape and appearance of the body,” said the bench.
It added, “The purpose of the surgery is not to improve the person’s appearance but to treat the root cause of the disease. Bariatric surgeries are undertaken by the appellant as life-saving surgeries and as a cure and treatment for life-threatening diseases. The same are in the nature of ‘healthcare services’, which are not taxable under the Finance Act, both prior to and after July 1, 2012.”
What new normal looks like
Masks, face shields, screens
Coronavirus is still very much here. But cities and nations have started ‘unlocking’ or trying to resume and reopen places and activities that were severely hit by the Covid19 pandemic. On September 14, school children in Italy, Portugal and some schools in Zimbabwe went back to school for the first time since March 2020. In some other countries like Germany, Vietnam, Serbia, schools re-opened earlier, but teachers and administrations are keeping a close watch. Eating out also now looks very different. PPE kits are a new normal for getting a haircut. In metros, every other seat is crossed out and weddings are going virtual. In this photo feature, we give us a glimpse of how the world has found its own ways to define the ‘new normal’ as nations try to recover from the body blow countries got as coronavirus hit people and the economy. Photo by Chethan Shivakumar/ BCCL
25 MPs test positive for coronavirus
At least 25 MPs have tested positive in mandatory tests conducted before the start of the 18-day Parliament session. The photo, taken in the Lok Sabha shows what new normal looks like in Parliament. MPs are wearing masks, face shields and there is a screen separating seating in the House. Photo: ANI
Social distancing in Kolkata Metro
Every other seat has to be left vacant in the metro and has been marked with a cross. This picture was taken inside the Kolkata metro. Photo by Kaushik Roy/ BCCL
New way to say ‘I Do’
Wedding guest Christian Wilmot livestreams as Gary Cheng and Sakiko Honda say their vows. They got married on July 4 at Marylebone Old Town Hall in London, England. Wedding venues were shut for months before that in the United Kingdom. Photo: Getty Images
London Wedding
So what if all their friends couldn’t join in. They live streamed the wedding so that their friends could still catch them exchanging vows and virtually join in the celebrations. Among the many changes to our ‘new normal’, weddings too have gone virtual. Initially, wedding venues were shut in the UK for three months. Photo: Getty Images
Schools reopen in Zimbabwe
A student has her temperature checked at the entrance of a private school in Harare, on Monday, September 14, 2020. Zimbabwean schools have reopened for examination classes after nearly six months of closure due to the COVID-19 pandemic. AP Photo
Italy: Schools reopen after 6 months
Primary school ‘Acquedotti’ reopened Monday, with four of its classes moved to a parish to increase spaces and guarantee social distancing between pupils. This is the first major step in Italy to normalise after schools shut in March as the coronavirus literally brought the country into a shutdown. For 6 months, schools were shut as Italy’s healthcare system grappled with the deadly virus. In this photo, a teacher welcomes pupils at the San Policarpo parish as Italian schools reopened, in Rome on September 14, 2020. AP Photo/Alessandra Tarantino
Social distancing in Serbian School
School children practice in PE class on the first day of the new school year on September 1, 2020 in Jagnjilo, Serbia. Serbia went into a lockdown in March and eased restrictions in May amid public discontent over confinement and despite warnings from doctors it was too early. Photo: Getty Images
Can you guess what this is?
Don’t let the shades of grey colour your imagination. These are socially distanced lines of customers who are waiting in the queue to get into an Ikea store in Warrington in the United Kingdom on June 1, 2020. The store opening saw large queues of people and traffic on adjacent roads as it reopened after the pandemic lockdown. The furniture and housewares chain reopened its stores across England and Northern Ireland subject to several restrictions, keeping its restaurants closed and asking customers to shop alone. Photo: Getty Images
Vietnam allows domestic tourists to travel
Vietnamese tourists pose for photographs on a boat touring Ha Long Bay, after the Vietnamese government eased the lockdown following the coronavirus disease (COVID-19) outbreak, on May 31, 2020 in Ha Long, Quang Ninh Province, Vietnam. Though some restrictions remain in place, Vietnam has lifted the ban on domestic travel, certain entertainment facilities and non-essential businesses to revive its economy. Photo: Getty Images
Bengaluru Temple gets ready
The Social Distancing boxes, sanitising and spraying of disinfectants on idols of deities were in full swing on September 12 at Kailasa Vykunta Mahakshetra temple in Rajajinagar hoping relaxation will be announced by State Government to open the temples for devotees. Photo by Anantha Subramanyam K/ MMCL
Temples start preparations for new normal
The Social Distancing boxes, sanitising and spraying of disinfectants on idols of deities were in full swing on September 12 at Kailasa Vykunta Mahakshetra temple in Rajajinagar hoping relaxation will be announced by State Government to open the temples for devotees. Photo by Anantha Subramanyam K/ MMCL
Berlin Open Air Theatre
Visitors watch a movie in a sold out open air cinema on June 05, 2020 in Berlin, Germany. As part of the easing measures concerts, cinema and other open air events are allowed from June 2 in the German capital, with a maximum of 200 people. The lock down measures have largely eased nationwide, with stores, restaurants and cafes open again, though under certain restrictions to avoid people crowding together. Photo: Getty Images
Zero contact ordering at restaurants in Delhi
Contactless ordering will be the new normal. Some restaurants are ready with zero contact ordering, where customers can use their smartphones to scan the menu, use QR codes to order and pay as well – all the ensure that there is minimum interaction with anyone outside of the diners they have come to the restaurant with. Photo by Anindya Chattopadhyay/ BCCL
Tenny Sandren in Italy
Tennys Sandgren of the United States wears a face mask as he waits for the coins toss ahead of his qualifying round match against Joao Sousa of Portugal during day one of the Internazionali BNL D’Italia at Foro Italico on September 14, 2020 in Rome, Italy. Photo: Getty Images
Restaurants open in Chile
A waiter, equipped with a protective face mask, face shield and disposable gloves serves guests at the re-opening of a restaurant in Santiago, Chile, on September 2, 2020. The Chilean Ministry of Health has authorized the reopening of restaurants with outdoor dining options and the reopening of other non-essential businesses in some areas of the Chilean capital. AP Photo
