European spa leaders want thermal medicine, prevention and rehabilitation more closely integrated into health policy as Brussels prepares its future tourism strategy
Europe’s medical spa sector is seeking a stronger position at the intersection of healthcare and tourism, arguing that thermal medicine and natural therapeutic resources could contribute more substantially to prevention, rehabilitation and healthy ageing.
The European Spas Association brought the issue to Brussels, gathering representatives from European institutions, health organisations and the tourism sector to discuss the future role of medical spas in European health and tourism policy.
The economic dimension is considerable. ESPA represents more than 1,400 medical spas, health resorts and facilities for treatment, prevention and rehabilitation. According to the association, the wider European sector supports around 850,000 jobs and generates approximately €50 billion in annual turnover.
Medical spas seek a place in prevention
A central argument emerging from the Brussels discussions was that medical spas should not be regarded simply as wellness facilities or tourism products.
ESPA President Siyka Katsarova called for spa medicine and health tourism to be more closely integrated into European health strategies, particularly in prevention and rehabilitation. The association also wants greater protection of natural therapeutic resources and more investment in their medical use.
The debate extends beyond the spa industry itself. Milena Angelova, a member of the European Economic and Social Committee and rapporteur on the EU Life Sciences Strategy, argued that natural therapeutic resources should have a greater role in disease prevention and future health policy.
“This should not be a side topic,” Angelova said, “but should be at the centre of any health strategy.”
The Brussels Declaration adopted in connection with the meeting calls for medical spas and climate health resorts to be recognised as partners in prevention, active ageing and longevity. It also advocates more research into fields including balneology and climatotherapy and closer integration of spa facilities into European research and clinical networks.
Health tourism enters the EU tourism debate
The discussions also connected medical spa services with Europe’s developing tourism strategy.
Maltese MEP Daniel Attard highlighted some of the practical requirements for expanding health tourism, including better transport connections to health and wellbeing destinations and a sufficiently skilled workforce. He also called for greater ambition in the EU’s future tourism strategy.
Elisabeth Kotthaus, Head of the Tourism Unit at the European Commission’s Directorate-General for Mobility and Transport, described health tourism as a promising field with considerable future potential.
The wider policy objective is to develop more balanced forms of tourism while helping individual regions address their particular challenges. Health tourism could fit particularly well into that approach because many traditional spa destinations are located outside Europe’s heavily visited metropolitan and coastal tourism centres.
Italy, France and Romania show different models
Several European countries already demonstrate how medical spas can operate at the boundary between healthcare and tourism.
Italy has developed one of the more integrated approaches. Marina Lalli, vice-president of Federterme, explained that therapeutic spa medicine is incorporated into the Italian health system, with treatments for certain medical conditions receiving public recognition and support. She nevertheless argued that greater emphasis should be placed on prevention rather than waiting until patients develop illnesses requiring treatment.
France represents another established model. Thierry Dubois, president of La Médecine Thermale and C.N.E.Th, stressed the role of evidence-based thermal medicine and called for greater European investment in research.
“We in this field are not asking for special treatment but, rather, recognition of the role spa medicine has in prevention and recovery,” Dubois said.
Romania, meanwhile, highlighted its extensive natural therapeutic resources and the use of spa medicine in areas including cardiovascular prevention and rehabilitation.
From wellness tourism to health infrastructure
The debate reflects a broader transformation taking place within health tourism. Traditional distinctions between medical treatment, rehabilitation, preventive medicine, wellness and tourism are becoming increasingly blurred as destinations develop programmes combining several of these elements.
For Europe’s historic spa towns, this creates an opportunity to reposition assets such as thermal and mineral waters, therapeutic muds and climate-based treatments within contemporary discussions about prevention, longevity and personalised healthcare.
The Brussels Declaration consequently calls not only for greater political recognition but also for research, digital tools for personalised prevention and long-term follow-up, stronger professional standards and protection of natural therapeutic resources.
If these proposals gain greater recognition within European health and tourism policy, medical spa destinations could increasingly find themselves positioned not merely as places for relaxation, but as part of a broader European infrastructure for prevention, rehabilitation and health tourism.
Image Credit: © AI generated illustration
