Section 6: Thermal establishments.

A doctor must be attached to each spa establishment as director or technical advisor. Failing this, and on a temporary basis, a doctor practising at the spa must be responsible for the medical supervision of the establishment. At least one nurse must be permanently on duty at the establishment during cure hours. Inspectors or qualified supervisors responsible for ensuring the correct application of the prescribed treatments must be assigned to…

Before taking up their duties, all members of staff must undergo a general medical examination comprising in particular : – a chest x-ray or radiophotograph, unless an x-ray less than two months old can be provided ; – a tuberculin skin test. In addition, employees are required to undergo a clinical examination every year, following which the occupational physician may prescribe any further investigations he deems necessary.

Each spa establishment must draw up and keep up to date a file for each patient. This record must indicate the financial conditions under which treatments are provided.

A spa providing functional re-education of the musculoskeletal system during thermal cures can only be approved if, in addition to the above conditions common to all private spas, it meets the condition of belonging to a spa specialising in musculoskeletal disorders.

As far as the premises and equipment are concerned, the spa establishment must include : 1° Essentially, a kinesiobalneotherapy department whose treatment stations must be equipped with conventional means allowing mobilisation under water. To this service must be added : a) Undressing cubicles, including some for patients lying down; b) Bathrobe drying facilities; c) Rooms with sufficient capacity to ensure that each patient being treated can rest for a suitable…

The paramedical technical staff authorised to carry out functional re-education practices must include one or more masseur-physiotherapists, depending on the size of the service. The rest of the staff must be sufficient in number and have the necessary skills.