Paul Simons, Chairman, British Spas Federation
Health Tourism is a huge market. UK residents take around 13.8 million spa trips per year and the market is estimated to be growing by 7.4% each year. It has attractive ingredients for UK tourism. It is not weather dependent. The individuals who are taking these holidays are typically amongst the higher spenders. It plays to the short break, which is where this country can score most heavily against the longer foreign holiday. ETC research suggests that properly marketed, this market could support 200 new health facilities in England, generating an estimated £650 million for our economy and 20,000 new jobs...”
Bath, the ancient City of Aquae Sulis is the one UK spa chosen by the Millennium Commission to receive national lottery funds to not only rebuild its spa but to act as the catalyst and exemplar for the revival of the British spa industry.

Why did the UK spas need reviving in the first place? What had happened to bring a once thriving national pastime to the point of extinction whilst the spas continued to thrive and develop amongst our Continental neighbours? The traditional spa had been:
◊ central to health care in the UK for many centuries
◊ a model for the National Health Service
◊ a socio-economic driver in many communities
◊ the origin of the ‘holiday’ concept
◊ the natural cross-over of the health and leisure markets

The traditional spa destination had ceased to be a viable entity and most facilities, housed in buildings often 100 to 200 years old, were in a poor state and declined into oblivion between the 1950s and 1970s.

Watsu treatment &View from Hetling, This computer generated image shows the new Bath Spa building rising up behind the 18th Century Hot Bath, with the curved glass façade at the foot of Bath Street which forms the entrance to the new Spa. ©Nicholas Grimshaw & Partners.

The origins of the British Spas Federation stem from the disruption of the First World War when the number and type of visitor to the spas and resorts were severely restricted. Many were also requisitioned for the war wounded, catering for as many as 75,000. The Federation, lead by Fortescue Fox M.D. of Strathpeffer and F.J.C. Broome of Harrogate was founded in 1916 to publish a guide of the Home Spas and to promote the merits of spa treatments. To counter criticism of spa treatments a “Committee for the Study of Medical Hydrology” was established and to this day the BSF maintains a Medical Advisory Committee.
The British Spas were declining and the destinations, usually blessed with good environments, hotels, parks and gardens, galleries, theatres and music festivals, re-invented themselves as ‘heritage destinations’ during the 1970s and 80s and the Federation concentrated on destination marketing. This received a boost when in 1990 the British Tourist Authority, recognising the potential of the spas to attract overseas visitors published “Spas 2000”, a strategy that sought to bring about a spa revival. The revival had to wait for the launch of the National Lottery in 1995 to see this manifested in a major grant being offered to the Bath Spa Project.
It is most encouraging that, following the impetus from Bath even before it opens, a number of the other spa towns are looking to develop new facilities and attract inward investment:
n Buxton – has a major development opportunity for a new hotel, spa, visitor centre and TIC in The Crescent including a supply of the natural, thermal, mineral water. This will complement the work of the University of Derby which has purchased the Royal Devonshire Hospital which will include a spa and hydrotherapy training school.
◊ Cheltenham – spa conversion of historic city centre chapel and new health and fitness club in central shopping development.
◊ Droitwich – proposals for a new brine spa, health and treatment centre in historic central park.
◊ Harrogate – an expansion of the Turkish Baths plus new treatment rooms and the re-development of The Royal Baths and TIC. Harrogate mineral water has recently been relaunched.
◊ Leamington – Healthy Living Centre initiative including promotion of local complementary therapists.
◊ Llandrindod Wells – opportunities to develop hydro-pool and treatment rooms at the Rock Park Spa Centre and associated hotel sites.
◊ Malvern – funding to restore the site of the natural springs and a commercial health and fitness spa proposal.
◊ Strathpeffer – re-opening of historic pump room with drinking facilities and museum plus scheme to re-open The Pavilion.

Above: Waterjet. Above Right: This computer generated image shows an aerial view of the new Bath Spa, with the Cross Bath to the left, the Hot Bath at the bottom of the picture to the right, the new Bath Spa building – a Bath-stone cube within a glass enclosure – in the centre of the image, and Bath Abbey and the Roman Baths museum to the top. ©Nicholas Grimshaw & Partners.

By contrast our Continental counterparts have maintained a thriving spa economy within their health provision and whilst recognising the inability of national health finances to sustain existing levels of spa ‘cures’, the industry has been able to manage a transition of some facilities into private and leisure based operations. This has not always been easy and not all European countries are following the same route or timetable. Some are trying to keep a strong medical grip on the mechanism that triggers provision whilst others are developing two and three tier systems.
The one single advantage that they have over the British markets is that their customers and communities have never lost their spa understanding, their ‘spa culture’ as it is called. Client perception of the value and therefore desire for the product exists, a market perception that needs to be re-created in the UK if we are to meet the targets of the English Tourism Council and fulfil the sectors potential.
However, within society, attitudes towards health have been changing. Health has moved away from being primarily based around avoidance and treatment of disease. Positive prevention is far better than awaiting the need for major intervention and we now hear of the complementary sector being integrated back into the NHS. So health issues are now seen in an entirely different context, one that is based around the ability to enjoy and control one’s life:
◊ Preventing illness
◊ Trying to reduce stress
◊ Controlling diet
◊ Widening interests
◊ Fulfilling potential
◊ Living more holistically and energetically
◊ Staying active for longer

Over the last decade the UK market has therefore gone through a significant ‘mind shift’ in how it sees the balance between work and leisure, business and family, health and wellbeing. There has never before been such pressure on time and so many options of how to spend it and one’s disposable income. This has seen the birth of the ‘lifestyle culture’ and in particular a greater interest and understanding of health issues across the general population.
The growth of health food, gyms and the investment in leisure facilities are all indicators that the consumer is looking for something more than relaxation during a break. Add to this the cost of our busy lives in terms of stress and it is no surprise that there is an increasing desire on the part of the customer to spend time pampering and indulging themselves as an antidote to their hectic lives. In satisfying this demand the latest data shows that there are already over 13,000 residential and 7,000 non-residential spa and sports facilities in the UK.
As has been shown the health tourism market in the UK is not as mature as that in Continental Europe but has more in common with North America. This brings some opportunities to the British market but also some problems of definition and perception of what is on offer in a typical UK spa. However, for this reason, the ETC decided to adopt the following North American definition:
“Health tourism encompasses those products and services that are designed to promote and enable their customers to improve and maintain their health through a combination of leisure, recreation and educational activities in a location removed from the distractions of work and home.”
A healthy break may be seen as an opportunity to re-energise, a sporting activity, an indulgent relaxation, or simply a way to escape or explore alternative ways to achieve a sense of wellbeing.
Although spa tourism in England – worth around £1.4 billion – is smaller than the sports sector, it is still at a relatively early stage of development. A total of 1.2 million customers, or 2.6% of the adult population, take a spa break, accounting for 7 million trips and over 21 million nights. However, this sector has the potential to double in the next few years.
◊ Three quarters of spa tourism spend goes abroad
◊ Industry estimates put the UK’s spa growth at 7% p.a.
◊ Spas represent 22% of health tourism spend but only 18% of trips
◊ Customers spend 66% more per trip than average, and it is with these high spenders that the opportunity lies
◊ The spa sector is broadening its appeal to be more mass market, and loosing its exclusive image
◊ 40% of UK residents are likely to choose England as their destination choice, which could increase given greater product awareness.

Top: View from Hot Bath.
This computer generated image shows the new Spa building, designed by Nicholas Grimshaw & Partners rising up behind the 18th Century Hot Bath. ©Nicholas Grimshaw & Partners.

Above: View inc Entrance.
This computer generated image shows the new Bath Spa building rising up behind the 18th Century Hot Bath. The Grade I listed Cross Bath is in the foreground. The curved glass wall beneath the colonnades of Bath Street forms the entrace to the new Spa. ©Nicholas Grimshaw & Partners.

For further information on the British Spas Federation, membership and services for members,
please contact: British Spas Federation, Abbey Chambers, Abbey Churchyard, Bath, BA1 1LY Tel: 01225 722291
E-mail: admin@britishspas.co.uk  Website: www.britishspas.co.uk

The author is grateful to the English Tourism Council for permission to refer extensively to its
published work on health tourism throughout this article. Copies of Health Benefits can be obtained from:
ETC Fulfilment Centre, PO Box 22489, London W6 9FR Tel: 0870 606 7204 Or via www.englishtourism.org.uk
Please quote reference ETC 8294 on your order