Editorial

The current controversy over the amount of sick leave being availed of by public and private sector employees and the extent of doctors' responsibility in issuing sickness certificates reminds us that sick leave remains a serious malady from which the economy suffers. The difference between what is being said today and what is normally said on similar occasions is that the administration is clearly accusing too many doctors with being either irresponsible or downright unethical in what it describes as their facile issuing of sickness certificates.

As one would expect, the medical profession has not accepted these charges meekly. The Medical Association of Malta, in fact, has publicly referred to an article by a Maltese doctor in a foreign professional journal which "clearly showed there was absolutely no rampant abuse of sickness certification" and claimed that the number of certificates per patient was low, as were the total number of days of sick leave per year per employee.

The doctors' union is insisting that the Ministry of Social Policy's claim about an excessive number of certificates issued during the hunting season "clearly has no scientific foundation". Yet, it is the experience of many people that during the hunting season too many fellow employees known to be keen hunters appear to suffer from a variety of ailments.

It is true that it is wrong to expect sick reporting to be spread uniformly over the year, since ailments such as feverish colds and respiratory infections are clearly seasonal, but it would also be a mistake to believe that most people are very scrupulous in reporting sick only when they are truly unwell. It is precisely for this reason that employers insist on sickness certificates and tend to wax indignant when they believe, rightly or wrongly, that some doctors sign certificates without going deeply into the patient's health. Indeed, doctors testifying before an industrial tribunal not so long ago declared that although they had certified an employee as being sick, on many occasions they had based their certification on what she had told them!

On the one hand, doctors protest that the doctor-patient relationship is built on reciprocal trust, a trust that can be abused, and that if a patient has been suffering from a fractured leg, one should not expect the doctor to examine him or her every week. On the other hand, however, the medical profession must admit that too many hard-worked general practitioners are only too ready to take a patient's word and to issue a certificate without much ado.

Ideally, each employer should have his medical officer who alone would be entitled to issue sickness certificates to his employees. But not all firms can afford to employ one or more doctors to do this job. What can certainly be done by most employers, public or private, is to tackle those employees who absent themselves, frequently for short periods, by interviewing them and discovering the underlying reasons for their behaviour. Such employees can also be reminded of a recent ruling by the industrial tri that an employee who absented herself regularly a few days at a time for a total of 55 days in one year because of complaints of a slight nature, could rightly be dismissed.

Perhaps the government should also consider the statement made by a medical correspondent that including a patient's ailment on a sickness certificate which can subsequently be used for, say, statistical purposes, is a breach of the Data Protection Act. If this is correct, the law or present practice should be amended.