Hospitals charges fees for various services provided along with medical and consultancy service provided by doctors such as nursing care, infrastructure facilities, paramedic care, emergency services, checking of temperature, weight, blood pressure etc. Also it hires senior doctors/ consultants/ technicians independently, without any contract of such persons with the patient; and pay them consultancy charges, without there being any employer-employee relationship.
Health care service has been defined to mean any service by way of diagnosis/treatment/care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India in the notification no. 12/2017 CT ( R ) dated 28.06.2017.
Since the service provided by the doctors hired by the hospitals whether employee or not are health care services which is exempt under GST in the notification mentioned ibid.
Health care services provided by the clinical establishments will include food supplied to the patients; but such food may be prepared by the canteens run by the hospitals or outdoor caterers maybe outsourced. When outsourced there should be no ambiguity that the suppliers shall charge tax as applicable and hospital will get no ITC.
If hospitals have their own canteens and prepare their own food, then no ITC will be available on inputs including capital goods and in turn if they supply food to the doctors and their staff; such supplies, even when not charged, may be subjected to GST.
Since Food supplied to the in-patients as advised by the doctor/nutritionists is a part of composite supply of healthcare and not separately taxable. Other supplies of food by a hospital to patients (not admitted) or their attendants or visitors are taxable. Therefore the foods supplied to the doctors and staff will be subjected to tax.