Questions I’d ask if I was a tax inspector #2: who is paying private medical fees in cash?

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I mentioned yesterday that I though I should  suggest some enquiries I thought HM Revenue & Customs should make to root out the cash economy and the tax evaders who populate it.

The criteria I suggested for these questions was that they have to be:

a) Systematic

b) Targeted

c) Highly likely to result in high quality information leading to worthwhile enquiries

d) Aimed at tax evasion

e) Aimed at higher net worth individuals.

I started by suggesting a question to be sent to all private schools asking for the names of all parents and guardians paying school fees in cash, which I understand to be commonplace. The next follows this broad theme, having with it in common the fact that the person enjoying the service can be unambiguously identified. This would be an enquiry to be sent to all providers of private medicine in he UK (including — and perhaps especially cosmetic surgery) along the following lines:

Please would you supply the names and addresses of all patients making payment of fees for medical services who have settled total liabilities exceeding £500 in cash in the last two years?

As with the school fees enquiry, the advantage of asking private hospitals is that the identity of the payment has to be unambiguously associated with a named person and address. There is also no risk to medical confidentiality — the detail of the procedure is not the subject of the enquiry.

I’d expect a significant revenue yield from enquiries resulting from such letters.


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