Development of the spa industry within Europe is founded on the interest of people from the earliest times in mineral springs that differed from ordinary springs in their appearance, taste and temperature. These ‘miraculous’ springs were used for cures primarily by the Romans, who came across them during their military campaigns, especially in what is now France, but also in other parts of Europe (modern Germany, Croatia, Hungary, etc.).

Following European tradition, in the past, and especially in the first half of the last century, the spa industry developed in mutual interdependence with the state overall, as society in the individual countries has developed. The essential framework of the spa industry is based mainly on the use of natural resources (including a healthy climate) with an important contribution from medical care and a comprehensive approach to therapeutic stays.

Today spa visits, health tourism, wellness, beauty and fitness programmes, regenerative, reconditioning and relaxation stays, are all dynamically growing products and tourist product packages which, combined with all-inclusive accommodation, catering, entertainment, sporting and other activities, are responding to the most challenging demands of individual tourists, as well as tourist offices and agencies.

Spa tourism in Europe has recently been going through a renaissance, and future dynamic growth is to be expected as a result of the unification of Europe – with the expansion of the member states of the Union. This not only means overall growth in the standard of living and the health awareness of the citizens of Central and Eastern Europe; it also involves preparing partnership agreements, assuming mutual co-operation within Europe in the fields of health and social welfare: i.e. potential extension of healthcare insurance to cover events abroad.

From the point of view of the potential of spa products, Europe has at least a thousand spa locations in almost all countries (with the exception of Scandinavia and some Baltic states, this number includes all the countries on the Continent and in the Mediterranean), with countless facilities and programmes for a variety of types, lengths and purposes of stays. Besides classical and traditional European therapeutic procedures, these key European centres continue to welcome new, alternative and modern trends, including Indian, Chinese and oriental treatment methods, and natural cures are enjoying a revival (Kneipp’s cures). Spa centres also more and more often include modern aquaparks, cosmetic centres and similar services.

The type of client at spas ranges from guests in search of a rest all the way to the truly ill, including all forms of prevention (primary, secondary and tertiary) up to rehabilitation and the treatment of chronic diseases. Spas are a frequent tourist destination of young and old, singles, families with children, and recently also a favourite venue for putting on congresses and conferences. Besides fixed schedule treatments several weeks long, short stays with a variety of durations are also possible. Healthy guests, especially, can choose among hotels and pensions of different price ranges, all available in spa locations. As far as medical treatment facilities, guests can choose out-patient centres located within and outside the centre of town, in-patient treatment performed totally or partially in a health centre, or in the case of acute illness, in a fully equipped clinic.

Curative resources:

a. Springs with medicinal water for therapeutic use
are in many spas and health resorts the basic and relevant aspect for being recognised as a health resort or a spa facility (by the state). Both areas of application are of importance, the internal use, e.g. for drinking and inhalation as well as the external use in bath-tubs or active therapies for example. Active therapies usually are open to the public and have to fulfil the existing legal requirements in the respective country.

b. Healing gases
Healing gases are also to be found in spring water, irrespective of being part of a solution (see 11a). Radon, H2S, CO2 are the gases to be applied. The recognition as a local remedy is subject to the law in the respective country.

c. Spas, spa facilities and health resorts at the seaside
These resorts usually apply thalassotherapies which are inevitably connected to the sea. The therapeutic use is linked with the immediate neighbourhood of the sea and its climatic influence (e.g. salinity of the air, possibility of swimming in the sea). Also with regard to thalassotherapy the distance to the seaside has to be fixed as an aspect for the recognition of spas and spa facilities then called thalasso centres (not more than 600-800m). Here a European standard has be established. Isolated substances of the sea (algae, silt) are also considered as part of a thalassotherapy. Since they may be well preserved in distant areas, however, they are also offered in resorts far away from the seaside.

d. Peloids in spas, health resorts and spa facilities
According to their definition as local remedies they are applied for therapies. Nearly all member countries agree on a definition of peloids which were produced during geological and/or biological processes and are used in treatments in form of compresses, packs or also in bath-tubs. Depending on their composition – organic and/or inorganic proportions – physical effects, e.g. thermal or mechanic, and also chemical effects may be achieved.

e. Bioclimate/healing climate
A suitable bioclimate that has been proven by an expert is an absolute must for these resorts in order to fulfil their task to spend health. Together with air purity that supports the therapeutic use of the climate it is an important requirement for these resorts. Healing climate is based on the therapeutic use of the local climate that, as a local remedy (stimulus-reaction concept), is the basis for being recognised as a health resort. Some member associations have defined it as a separate health resort type.

f. Kneipp therapy
Often mixed with elements of the Priesnitz therapy it is frequently applied in spas, health resorts and spa facilities though often only applied in parts. In order to be recognised as an individual spa type it has to apply the complex and wellstructured treatment concept according to Kneipp.