Study 'dispels' claim of abuse in sickness certificates

A study by family physician Jean Karl Soler showed there was absolutely no rampant abuse of sickness certification by local workers and doctors, according to the Medical Association of Malta.

Referring to an article in The Times about "warning letters" sent to 200 doctors for issuing an excessive number of sickness certificates to certain patients for the same condition, the MAM yesterday said the recent study by Dr Soler, published in the international scientific journal Biomed Central, showed that the frequency of sickness certification was similar to that reported in other European countries, even though the reporting of sickness certification system was far less complete in many other European countries than locally.

The MAM said the study clearly showed there was absolutely no rampant abuse of sickness certification as implied in The Times story quoting sources close to the Ministry of Social Policy.

"Indeed it was shown that although company doctors were issuing certificates to a large number of employees, which in some cases could be around 1,000, the number of certificates per patient was low, as were the total number of days of sick leave per year per employee."

The medical association also said it looked at the seasonal variation in sickness certification. It said that scientific studies published by Maltese authors in leading international journals showed distinct seasonal variations in many common diseases such as asthma. Influenza and other common respiratory infections are among the diseases well known to show seasonal variation.

"The pattern of sickness certificates, as expected, follows these seasonal trends of disease. The conclusion reached by the sources in the Ministry for Social Policy - that these seasonal variations were related to hunting - clearly has no scientific foundation. The notion that seems to be held by these sources, namely that sickness certification should be evenly spread throughout the year, is completely erroneous," the MAM said.

Martin Balzan, the association's secretary general, explained that seriously ill patients were being greatly inconvenienced by having to get sickness certificates every week: "For example, a person severely paralysed after a stroke and another one with a terminal illness now have to call to a doctor every week."

Dr Balzan said the medical association would like to appeal to the social policy officials to change their attitude. "They have to be sensitive to patients' needs and come forward with positive changes in those procedures which are causing so much unnecessary hardship. We believe that the best way forward is to hold constructive talks with a view to improve the system so as to close any possible loopholes without causing inconvenience to genuine patients."

Last month The Times published figures obtained from the government, which were also shown to the MAM, and which indicated that doctors issued over 170,000 sickness certificates in eight months.

Over 90,000 of the certificates were issued to employees in the private sector and about 80,000 certificates covered public service employees.

One particular doctor issued more than 3,500 sickness certificates in eight months. Another doctor issued 22 consecutive certificates to the same person for the same condition.