SECOND OPINION:Abusing sick leave and underperforming are forms of bullying
CONTRARY TO popular belief, only a small minority of HSE staff abuses sick-leave entitlements.
The number of non-genuine sick days taken by a few people distorts the statistics. Like bullies, those who take non-genuine sick leave are blatant and manipulative, and have a disproportionate negative effect on work colleagues and the entire organisation.
Sick-leave abusers complain of illnesses that cannot be medically confirmed and, short of calling them out-and-out liars, they are hard to manage in a system that allows seven self-certified sick days in a rolling year.
Reducing the number of self-certified sick-leave days to seven over a rolling two-year period will help HSE managers deal with the problem.
Absenteeism rates due to sick leave are based on average working time lost per employee per year and are 5 per cent, or about 10 days, for the HSE and 2.6 per cent, or six days, for the private sector.
Doctors and dentists have the lowest rates, whereas nurses and support staff, such as porters, have the highest.
A 2011 UK report by health and business experts Carol Black and David Frost found that lower sick-leave rates within the public service were “undoubtedly” due to better management.
Rates for Irish health services are almost identical to those in the UK health sector.
As Terry Leahy points out in his new book, Management in 10 Words, when self-certified sick leave was introduced in the UK, absenteeism rates crept up from 4 per cent to 7 per cent, and to 10 per cent in some Tesco stores.
Leahy argues that changes in employment law led to a culture of entitlement. This is exactly what happened in the HSE.
Social partnership agreements and benchmarking created a sense of entitlement, not only to non-genuine sick leave but to extended periods of certified sick leave, compassionate leave, flexi-time, time in lieu, and so on.
Staff ended up with a generous, flexible leave system without having to reciprocate with improved performance.
Managing sick leave effectively will not solve absenteeism in the HSE. A more insidious kind of absence is when employees turn up for work but are not present in any way that counts.
They are the people who are five minutes late for every shift and leave five minutes early, in effect giving themselves at least six extra annual leave days.
They are the people who arrive on time but spend half an hour having breakfast in the canteen or hours distracting their colleagues with gossip and long coffee breaks.
They never volunteer to do anything extra, work half-heartedly and are “absent” to service users, co-workers and the job.
All organisations have these underperformers and the HSE is no exception.
Although a minority, underperformers have a pervasive negative effect on morale, trust and the culture of an organisation.
These “free-riders” create mistrust, which can absorb the energy of hard-working employees to such an extent that they cannot do their job.
Abuse of sick leave and underperformance are actually subtle forms of bullying because of the effect of both behaviours on other staff.
Leahy recommends a “tough love” policy, which means acting immediately and not ignoring seemingly trivial practices.
HSE service users who do not attend appointments are another absentee problem.
In May 2012 almost 41,000 patients did not attend scheduled appointments, with 70 per cent missing second and subsequent appointments.
So the health system has three absenteeism challenges: non-genuine sick leave, underperformers, and those who do turn up for work having no one to treat.
If sick leave is costing half a billion a year, underperformers and non-attending service users are probably costing at least another €1 billion.
Dr Jacky Jones is a former regional manager of health promotion with the HSE