The debate on whether GPs are over-zealous in issuing sicknotes continues to
rage, with equal passions in the pro- and anti-GP camps
Employers and staff must work together
I read with some concern certain responses to the work-related stress issue
(News and Letters, 19 August). What leads employment law specialists and
personnel managers to believe they are better qualified to judge whether or not
an employee is fit for work than an employee’s own GP?
Yes, work-related stress does appear to be the new ‘bad back’, but working
practices have changed fundamentally over the last 20 to 30 years. Companies
are constantly downsizing, re-structuring and effectively achieving the same or
greater profit margins with fewer staff.
To dismiss work-related stress as an excuse for malingerers and to accuse
sympathetic GPs of being unprofessional is to completely miss the point. With
changing work practices come changes in how that work will affect the
Yes, we have businesses to run, but our GPs have a society to care for.
The best approach all round is for employers and employees to learn to work
in partnership – and who better to drive that initiative than our lawyers and
Organisations need to stop passing the buck
Doctors exist to treat sick people, believe it or not, and none of us would
want to visit our GP and be told we are wasting their time.
If an individual wants to spin their GP a line there is very little the GP
can do to prove it false. Blaming GPs for lending a sympathetic ear to people
who claim to be ill is like blaming a trade unionist for demanding a pay
increase for their members – what do you think they are there for?
Organisations that experience above-average rates of absenteeism need to
look at how they are managing themselves, not cast around for something or
someone else to blame. No wonder Personnel Today constantly carries whinge
pieces about HR’s inability to sit at the top table. GP’s do not exacerbate
absenteeism but head-in-sand HR practitioners certainly do.
Senior training and development officer, Rochdale MBC
Don’t diss stress…
Most of your letters (19 August) seem represent a view that the majority of
sick employees are whining skivers who simply know how to ‘work the system’.
Shame on anyone who takes this view. I hope none of you ever experiences
mental illness in your life. But if you do, you may come to understand the
devastating effect it can have.
Granted, there will always be a minority of people ‘throwing sickies’, but
it is more often the conscientious people that suffer most as they strive to
meet the expectations of others and themselves.
Stress may not currently be classified as a clinical condition, but the
symptoms are real, physiological reactions to the environment around us.
Everyone reacts differently to different types and different levels of stress
due to the balance of chemical within our brains. Those of you with high
tolerance to a wide range of stressors, good for you, but it is not something
to feel superior about, more like good physiological fortune. A little research
will inform even the most cynical how stress develops, its symptoms and the
reasons that it has become a modern-day phenomenon.
It disgusts me that mental illness is not taken more seriously, particularly
by HR. HR practitioners are so busy trying to make an impact on their business
that they seem to have forgotten the reason they are employed in the first
place – people. Yes, business success is very important, but no business will
operate efficiently if its people are not in good shape.
It’s time for all you naysayers to get some perspective and facts on this
issue. Do the cynics out there feel good about themselves for being so ‘down’
on fellow humans?
Good on you Terry Lunn (Letters, 19 August) for speaking up – work is never
the be all and end all for most well-balanced individuals. A happy and healthy
life is far more important on an individual basis. HR and business will only
win if they can learn to grasp this concept and blend it with the needs of
business. Until that time, I fear we will continue to see ill-informed
commentary on this important issue.
Management development adviser, Tube Lines
Consultant report is more use than GPs
I share the frustrations over the production of GP reports on employees’
state of health.
Everyone will be well aware of ‘disciplinary stress syndrome’, where an
employee under threat of a disciplinary procedure goes off sick with stress,
supported by a GP’s letter. I’m sure it doesn’t take much to convince a GP you
are suffering from stress.
I do have some sympathy with GPs. Their job is to protect their patient and
take on trust what they are being told. They may have no more than five minutes
to make a diagnosis and cannot be expected to take the employer’s concerns into
As an ex-personal injury lawyer, I know GP reports are almost worthless, and
are certainly not acceptable in the courts, so I would always advise seeking a
consultant’s report. This takes longer, and is more expensive, but is far more
I would also advise an employer to be very clear in the questions asked, and
to make sure the consultant gives answers to difficult questions. Don’t be
brushed off. After all, you are paying a lot of money for the consultant’s
In addition, a consultant will not have the same close and continuing bond
with his or her patient that a GP will have. I would use GPs as a first line of
enquiry but for any difficult or long-term cases, the extra cost of a
consultant must be worth it if it avoids the difficulties that Paul
Robertson-Marriott describes (Letters, 5 August).
Head of legal affairs, British Printing Industries Federation
GPs should foot bill for statutory sick pay
The system as it stands needs to be radically changed so that those doctors
signing people off sick are held more accountable for their actions. One
solution could be that the hospital, practice or clinic foots the statutory
sick pay payments for the duration the person is ill, unless the illness is
directly attributable to the work environment in which that person operates.
We currently employ staff in a manual capacity, involving the repetitive
stacking of a product. The basic requirement is that they can count to 10.
Where is the stress in that? However, our local GPs feel this is a particularly
stressful line of work judging by the sicknotes received.
Personnel and health & safety manager, Company name supplied
Casualty doctors are also part of problem
It is not just GPs making the problem worse; it is casualty department
doctors as well. How can they know what alternative or ‘light duties’ a company
has to offer an individual with a fractured wrist, for example? By signing them
off work for several weeks – even if we get them to see an occupational health
doctor who may confirm they are fit – we cannot force them back to work before
their sicknote runs out. Very frustrating.
HR & EHS manager, AFL Telecommunications Europe
Duty of care extends to colleagues as well
I recently saw a certificate that simply had ‘unwell’ as the reason for the
absence, while a colleague saw one that stated ‘malingering’.
The most commonplace reason, as indicated by other contributors, is stress,
with just about any other activity being sanctioned as therapeutic. What about
the employer’s duty of care to remaining staff who become stressed covering for
colleagues off with stress?
My overall concern is that GPs are paid by the NHS on a per capita basis, so
there is no contest as to who they are ‘serving’.
Is employee having a belly laugh at us?
We have had an employee off sick since February, diagnosed with a frozen
shoulder. She is attending computer skills classes once a week, as well as a
belly dancing class. How is she unfit for work?
She says the frozen shoulder was caused by the work she does, when, in fact,
she had a bad car accident five years ago in which she sustained injuries to
her neck and ended up with a broken collar bone.
We can’t get full reports from her GP and have to employ an occupational
health doctor to get the answers for us. So far this has taken six months of
our time and we don’t have a return-to-work date yet, and we can’t sack her.
Who says working in HR is easy?
Name and details supplied
Consultation with an employer is crucial
In my previous role, an employee submitted a sicknote that clearly stated
"will never be fit to return to work". The employee subsequently
requested early retirement on the grounds of ill-health (IHER). However, when
further investigation highlighted that she had never joined the pension scheme
and was therefore not eligible for IHER, her GP submitted a further note that
returned her to work within two weeks.
In this instance, the illness was genuine and the employee still suffers
from constant absence and, in reality, is not fit for work. The point is that
because she requested her GP to submit both notes, he did so.
GPs would be wise to obtain more information from companies before issuing
sicknotes. They currently base their decisions solely on the employee’s comments
and, in some cases, these comments can be exaggerated to get time off work with
Name and details supplied
Not wrong to expect staff to do their jobs
Terry Lunn’s response to the debate on GPs and the use of medical
certificates is greatly disturbing (Letters, 19 August).
While the majority in HR have the interests of employees and the business to
balance, I think he must realise that business is about people. If we took his
stance then no business would grow, people would be able to behave in organisations
as they saw fit and the economic future would be dire.
Organisations need people, people need organisations. We all have a
responsibility to our employers, the need to co-operate and to obey reasonable
management instruction. Is it wrong then to expect an employee to do what they
are paid for, at the times they have agreed through their terms and conditions?
No, it is not.
Senior HR adviser, Phileas Fogg Company