Spa tourism in Greece: Challenges and new opportunities for investors and key players

Ι. CONCEPT AND LEGAL CONSOLIDATION OF THERAPEUTIC SPA MEDICINE.

Considering the growing scientific need to link an individual’s physical health and mental with both its men-tal and social wellbeing, for the purpose of not only suppressing but also preventing morbidity, Therapeutic Spa Medicine returns to the fore as being the most timely and efficient form of holistic theory. Using inter-nationally recognized methods that focus on the national thermal wealth development and its benefits, Therapeutic Spa Medicine functions, additionally to classical medicine, as a therapeutic supplement for pa-tients aiming not only to cure their diseases, but also to improve the quality of their lives by adopting a model of healthy living and treatment.

In our country, Therapeutic Spa Medicine is widely known in many practice areas of classical medicine and in dentistry as well, since 1952, through internationally established forms of Clinical Hydrotherapy, Thalas-sotherapy and medical Klimatotherapy. Nowadays, Therapeutic Spa Medicine not only enjoys global scien-tific recognition by the World Health Organization (WHO), but through extensive legislation is explicitly pro-visioned by the national health care system, with the possibility of acknowledging spa tourism units, thera-peutic tourism and thermalism-thalassotherapy centers (as these are defined by article 1 of the Law 3498/2006) as primary health care units (PHU). More specifically as to that, the terms, the preconditions and the procedure provided for the acknowledgement of the above mentioned units as primary health care units are established, according to article 40 par 2b of the Law 4272/2014, by the joint decision of the Min-isters of Health and Tourism, while the acknowledgement is carried out pursuant to a decision of the Min-ister of Health upon relevant request submitted to the Directorate for the Primary Health Care of the Min-istry of Health.

ΙΙ. CROSS BOARDER PATIENTS’ HEALTHCARE AND EXTENSION OF THERAPEUTIC SPA MEDICINE SERVICES WITHIN THE EU COUNTRIES THROUGH THEURAPEUTIC SPA TOURISM.

Furthermore, through the implementation of the provisions of the Directive 2011/24/EU of the European Parliament and the Council of 9 March 2011 for the patients’ rights in cross-border healthcare (L 88/45/4.4.2011), integrated into the Greek legal order by the Law 4213/2013, it is established the concept of Health Tourism which includes Medical and Dental Tourism, Therapeutic Spa Tourism - Thermalism and Wellness Tourism. By this term, it is considered the cross-border "transfer" of health care services, which enables the prescription of the appropriate medical treatment to a Member-State different from the Mem-ber – State of affiliation, and in addition the full medical and pharmaceutical coverage of the patient by the relevant medical institutions of the host country. According to the abovementioned Directive, and subject to the provisions of the EU Regulation No 883/2004 on the coordination of social security systems (herein applicable as to the sickness benefits of art. 3), article 7 par. 4 states that: “The costs of cross-border healthcare shall be reimbursed or paid directly by the Member State of affiliation up to the level of costs that would have been assumed by the Member State of affiliation, had this healthcare been provided in its terri-tory without exceeding the actual costs of healthcare received.” Hence, social security promotes Health Tourism through relative legal provisions for the consolidation of patients that are subject to the relevant social security systems of the Country they reside.

Subsequently, as an integral part of Health Tourism, Therapeutic Spa Tourism endeavors to expand its ther-apeutic methods through the development of national thermal sources for the benefit of thousands of pa-tients worldwide. It is noted that the Panhellenic Medical Association has established more than 35 geo-thermal sources (out of the total 752 geothermal sources founded in a large scale) in Greece, a country distinguished for its special bio-climate and the healing properties of its thermal sources.

Therefore, given the fact that Therapeutic Spa Tourism constitutes the most contemporary therapeutic ap-proach for the healing of a variety of diseases, including, among others, many autoimmune diseases such as psoriasis, musculoskeletal diseases, diseases of the nervous, respiratory, cardiovascular, hematopoietic, gastrointestinal, urological and endocrine system and in dermatological, gynecological, allergic and perio-dontal diseases etc., it undoubtedly contributes in the prevention, preservation, treatment and rehabilita-tion of health, in cases where classical medicine has proven inadequate to provide patients with the appro-priate medical treatment.

ΙΙΙ. PROSPECTS IN THE ECONOMY SECTOR – THE “OPENING UP” TO INVESTEMENTS

Apart from the obvious benefits generating in the health sector, the above described action promotes, in parallel, a strong "opening up" of the economy in sectors with special and timeless investment interest. Given the unavoidable coupling between the sensitive sector of health care and tourism, the revenues and economic benefits for potential investors are considered to be multiple, with direct - medium term applica-tion and a growing trend due to the opening up of prospects for the sustainable development in therapeutic spa tourism.

Possible interested parties - beneficiaries of such an investment with direct reference to the permanent connection between patient and provider of therapeutic spa tourism services become, among others, the following:

• Tourist and hotel companies, which will house the therapeutic spa tourism services, providing these services as certified primary health care units or/and providing accommodation and other infrastructures to moving patients in the adjacent, to therapeutic spa centers, residences through-out the year and not only during the tourist season.
• Tour operators which will link moving patients to certified therapeutic spa tourism institutions and hotel accommodations.
• Local Authorities in which many recognized therapeutic - thermalistic institutions are included.
• Associations and organizations of patients with autoimmune diseases, acting at both national and European level, to which the involvement with national authorities for the provision of such health services to their members appears as high priority.
• Private insurance companies which, through additional insurance risk coverage programs (that risk on preventing and combating diseases by therapeutic tourism benefits) can cover additional costs and expenses that deviate from those in the relevant legislation covering national security institutions.
• Doctors, dentists and other health professionals (e.g. psychologists, physiotherapists, beauticians, kinesiologists, etc.), that specialize in holistic/healing medicine, will staff certified therapeutic spa tourism institutions.

The best possible interface of all the above mentioned groups in order to fulfill legal prerequisites is the most appropriate and effective guideline. Moreover, Therapeutic Spa Tourism not only ensures the suc-cessful implementation of the program to the advantage of thousands of patients, but also promises pro-spective development on many other related areas with high scientific and investment interest for both individuals and enterprises with a similar business scope.

Mariangela Vlagopoulou

Partner, Attorney at Law-LL.M

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