By Liam Carr
First posted on http://liamrcarr.blogspot.com/2011/11/doctor-doctor.html
The much maligned NHS health and social care bill is on its way though Parliament: The government want GPs to spend time looking at budgets and balance sheets. They have now got it wrong in another way; they want civil servants to decide who is sick. A government backed report summarises “People should be signed off for long-term sickness by an independent assessment service and not GPs”1 In the same report they also offer tax breaks for employers as a reward for taking on the long term sick.
It goes without saying that GPs are best placed to decide who is sick. They have a broad understanding of health and can take a holistic approach, and importantly they can look at each case individually. They do not have targets on how many people to send back to work. An ‘Independent assessment service’ may not be afforded such freedom.
The report also states that “77% of GPs had admitted they signed people off sick for reasons other than their physical health”1 In this category there will be people off sick with work related stress, without significant adjustments not only to working conditions but also management attitudes towards stress in the workplace. There are still managers that are of the opinion that staff who are suffering from work related stress are simply incompetent. By blaming the employee the managers wash their hands of all responsibility and fail to make changes that could be of benefit to all.
The government could take a different approach: Employers, Unions and doctors could work together to action to reduce levels of sickness absence. A union rep, member and manager can easily have a meeting to agree strategy for a return to work after a Doctor has decided a person is fit for work. Reasonable adjustments to the workplace, flexible working hours and a phased return could be agreed. It is for the employee and the employer to agree the terms of a return. Legislation already exists to make this a reality ‘reasonable adjustments’ as outlined in the Equality Act could be applied to all long term sickness cases. In my experience managers are more than willing to have these meetings but less than willing to make sure that real adjustments are made and followed up on. This inaction on the part of the employer can lead to deterioration of health, wellbeing and further sickness.
On its own this change is worrying if we add it to other recent Tory proposals we can see that if they become policy there will be a real erosion of workers basic rights. Another proposal; removal of the right to a tribunal if you have been at a place of work for less than two years, is a cynical move. Industrial tribunals are thankfully rare, (which begs the question why legislate against them) they only needed if a dispute is completely unresolvable by conventional negotiation. For some workers however, for some workers is the only means of justice. The right to a tribunal is a right which we should all have but hopefully, and usually, one that we will never use. Some people go through working life not staying at the same place of work for more than two years, following the work and going from one fixed term contract to another. These workers will never have the right to a tribunal, regardless of how they may be treated by an employer.
These two issues are not unrelated, It will be easy for an employer to not make adjustments when somone returns to work after sickness and easy to dismiss them without a tribunal when they again become sick.
The Coalition government will say that these changes to sickness and tribunal legislation are are needed for economic recovery. What they should be more concerned about are the million young, healthy unemployed people who are sick of the lack of policy to address this very real and immediate concern.