NHS staff - 50% higher rate of sickies

[SeanMacGabhann]

or the Chair stepped in when Hal suggested something was amiss and clarified a point of order?

a shame you have taken to fictionalising my mornings as well now. My contact with anyone "behind the scenes" has been zero.

Nice post btw quids..

[mockney piers]

Forgive me chair whilst I offtopicate, but on a Monday morning it's all I can do to struggle out of bed and get to work. Chairing hasn't been part of my morning either.

Can someone skive off unpaid unappreciated roles in the voluntary sector?

Anyhoo, back to NHS (with a little more debate and a little less speculation or churlish posts like this one please).

[MrBen]

Come on.I was only trying to lighten the tone Mockney.You know I appreciate forum admin is voluntary. And my earlier post - I hope gets firmly back to the debate.

Sean apologies for fictionalising your commute in can we call a truce on this one?

Edited for the benefit of a return to constructive debate.

[mockney piers]

Monday mornings I find it hard to be anything but churlish I'm afraid, apologies.

I've only ever worked private sector, but my mum Unt and uncle were all lifelong NHS frontline staff (speech therapist, nurse and consultant surgeon respectively) and all were hugely dedicated.

Private sector certainly is well capabale of employing substandard people and not doing enough to get them working, trained or sacked, especially if a manager is seeking to save face. My missus has encountered some pretty awful people and real institutional intransigence in the public sector, and as dat as I can tell though far from unique to public sector it does seem more entrenched.

I've no experience of back office in the NHS but I'd be surprised if that atttude doesn't pervade NHS civil service staff in the same way it did the industries that the missus worked in.

I think mr ben and quids have very fair points in saying that the public sector should be open to impassijnate scrutiny in the same way that shareholders can hold private sector management to due diligence in minimising waste and maximising efficiency. No worker especially front line staff need take this as a personal attack, it's surely only sensible to have openess and transparency in any large, especially public institution. It should also be possible to take on findings at face value.

[david_carnell]

Could I suggest that this argument is being looked at from the wrong angle?

Perhaps rather than question why NHS staff have more sick leave as abnormal or a sign of "skiving", no-one has questioned whether it is the private sector where staff are being forced to work, for various reasons, when they should be in bed.

Perhaps it is the private sector ethos of "profit-at-all-costs" that should be addressed? Are the job security and HR management of private sector employees little more than Dickensian work-houses where absence is punished to such an extent that honest workers will now trundle into work, spreading germs amongst their colleagues, and perform to a sub-standard level, merely to ensure a perfect attendence record. All the better to climb the greasy pole.

The French have a saying of "travallier mons, produre plus" (sp?) which loosely translates as "work less, produce more". Return to work refreshed after a period of sickness or ill health and your level of work and desire to pick up any slack will be doubled. Work through (presenteeism, as I understand it), with coughs and sneezes, and the amount of work produced is rarely even worth the bother. And you do nothing but irritate commuters and colleagues with your endless sniffling and wheezing.

Workers should not be made to fear the rod every time they need time off. If one wishes to highlight NHS inefficiencies I would suggest looking towards the endless number of private sector "consultants" who are brought in for extortionate fees to advise on business practices (and have brought in these ridiculous absentee management systems) for very little effect. I would hazarda guess that millions are wasted on such snake oil salesmen. Or the infamous NHS IT system that was entrusted to the private sector to enact and is running years late and billions over budget.

Yet the private sector still has the temerity to be smug and self satisfied with its performance and to lecture those of us who work in the state sector on reducing inefficiencies.

Those in glass houses.....

[Keef]

Can I just say that a lot, if not most, of public sector workers could be earning a lot more doing similar jobs in private sector. Surely the perks like pension and leave, just make up for the lower salary. I gave up my safe permanent public sector job, and now earn quite a chunk more as a locum. I'd accept lower pay in return for some perks, I don't see what is wrong with that. I just wish the NHS were paying my missus maternity, so I could actually enjoy my higher pay! Grrr!

[SeanMacGabhann]

wow - I've just noticed there have been edits and everything? Truce? Well it looks like the conversation is going to be more possible. I still don't think I misrepresented anyone tho, so if I am clueless on that score and anyone remains hacked off with me then maybe PM me and I'll try and straighten it out

I think a lot of interesting stuff has been overlooked in the pages to date - Annaj in particular has posted at length making some good points and fair play to quids he has said he will digest further

Some people like brum dipped their toe in the waters as well with some salient points -

When I reread the whole thread this morning (just to reboot my head), it occurred to me how few of the points have been addressed, so there is a risk of people repeating stuff that others have gone to the trouble of already pointing out

[????]

Cripes - I've just read through all of this again and can see what a jumble of arguments and a mess this thread is. In honesty I think there are several strands going on and I think that the direction the thread took yesterday was not helpful either.... as we all now seem to have agreed and subsequently calmed down. I'm not sure wether to address this from my perspective or get back on specifics. I think it is the threads ambiguity and subject matter that perhaps makes this a bit of a jumble - both the thread and what I'm going to add now! This is WIP.

1) The OP was specifically focussed around a specific issue - the report in the Times, which much of the initial reponse focussed on, however I think the poster's intention was using this as an 'example' of possible Public Sector inefficincies intended for a wider debate. Please correct me if I'm wrong MrB but that's how I read it. Certainly the 'critics' on this thread - MrB, Myself, TLS earlier on, have quite often stressed we are talking PUBLIC Sector - and back room functions - whereas the 'defenders' have focussed almost solely on the NHS (largely reflecting both their experience/careers), front room staff and the contents of the report. An unfortunate ambiguity.

2) The OP was also somewhat provocatively worded/labelled etc and I can understand why initial reactions were like they were and with hindsight I think MrB made a mistake with that provocative position which he has tried on several posts to diffuse. Unfortunately this set the tone for the thread, which is a pity as the general subject matter is important but potentially thorny and emotive (for all of us) so we would have been better, again with hindsight, to have had a clear less leading theme to 'debate'

So we are left with several different debates going on, and again I think the debate is slightly different depending on wether we are talking the NHS or the Public Sector in general

1) Does the Pub. S take more sickness than the Private?

if so,

2) Does that actually matter?

3) Why are they different?

4)If we think they matter, what can be done to make them better...(including the possibilty to get the Private Sector to take a more public sector approach to sickness/recovery)

It's late, i'm tired I have views on all of these and many of them have been covered by many solid contributions from ALL of us so shall we try and get some clarity and continue with this as a proper drawing room discussion or let this one go?

[macroban]

The original assertion was that NHS staff take more fraudulent sick days ("sickies") than private sector workers.

????'s new question to help move this discussion forward is "Does the Pub. S take more sickness than the Private?".

This is not a neutral question but incorporates a rhetorical device. I could rephrase the question: "Do private sector workers take less days off sick than public sector workers?".

I'm with ???? in his call for clarity, but the problem is that we have not yet seen any reliable private sector data from payroll sources.

[HAL9000]

???? Wrote:

-------------------------------------------------------

> ... what a jumble of arguments and a mess this

> thread is. ... there are several strands going on ...

This is where multi-threaded software would offer a great advantage: it groups sub-threads together as a debate bifurcates.

It requires far more discipline and concentration to keep up with all the different voices when messages are displayed one after the other as they are on this forum. I'm not complaining - just saying: a solution exists.

[????]

Macroban

In terms of the data, I think the source generally quoted is the CIPD ,which I believe is largely based on survey data returned from HR departments in the public and private sector. This is I'm sure robsutsly and professionally collected put together and put to scrutiny. The CIPD is a well respected professional body and the findings of their annual report on sickness are widely accepted by most, including the authors of this report mentioned in the original post.

[SeanMacGabhann]

Quids - yeah I had many of the same thoughts when I re-read it too

Anyway to answer your questions, in order

1) I would say yes

2) Not necessarily, and to me personally in this particular case no. But depends on who you ask. In the case of the NHS report at the beginning I'm not especially bothered because it doesn't set any alarm bells ringing/ 50% more sounds like a lot but when it's 5 days a year versus 10, in that environment I don't conclude that those extra days are easy-living skives. What would matter more is that about the same, worser or better than previous decades?

3) Why are they different - several of the earlier posters from the NHS have given plenty of reasons - anything I add would be speculation but I'm sure others can add more. As for the back office staff MrBen has experienced I'm willing to believe there is a fair bit of that goes on - but not so sure it's worse than anywhere else. Many places will have a much lower absence rate but in and of itself that doesn't strike me as simply a definite goal. Presenteeism is as bad as absenteeism and often makes people miserable - the old maxim, noone looks back at their life and wishes they spent more time in the office holds true

In front-line roles, be they doctors, nurses or Helpdesk staff in an office, turning up and being there is critical. In other back-office roles, the jobs can be cyclical - several big projects with a looming deadline is not the same as post-deadline and a few new projects kicking off. If people were absent in the latter case I would be far less bothered for example. My main beef with slack employees is not knowing what their job is and not getting it done. If you get it done then 9-5/5 days a week rules don't seem as important. To me anyway

[annaj]

Quids, out of respect for your thoughtful, diplomatic and concise summary I'm staging an un-flounce.

And in response to your summary questions:

Firstly I would say, generally, that the distinction between NHS and wider PS is important, because I think the NHS is different to any other organisation in this country in terms of size, function, diversity and philosophy. That is not to say that the NHS is perfect, untouchable or beyond question, just that, in my opinion, it is different.

1. Yes, based on the data I've seen. There is a higher rate of sickness in the PS generally and the NHS ranks about half way within the public sector and higher than the private sector. However, because the NHS is different, the comparison to the wider private sector may not be a fair, relevant or representative one.

2. Yes. In the case of the NHS it matters because of what it represents, which in my opinion, based on the findings of the report, is an unhealthy working enviroment with high levels of injury, stress and bullying. It does also matter financially, but for me that is a secondary concern. If we could redirect money to services by saving it on temps and agency fees, that would be a great bonus, but the important story here is the miserable and unhealthy workforce. Failing to see the signs of a declining and demoralised workforce now could cost an awful lot more in the future than could be saved by chasing people back to work and stamping out duvet days. In the context of the wider PS, yes, I can see that increasing efficiency, by decreasing sickness would benefit everyone, as long as those who genuinely need time off are not left vulnerable, but it's not the point of these figures for me.

3. I think I've already covered why I think work within the NHS is different and I'm anxious not to go over old ground or draw accusations of being overly emotive. The issues that I've raised do apply mostly to clinicians, but MrBen's example that as the IT support guy he was called in to fix systems that had failed in front line services shows that, actually, everyone is affected to an extent by the stress of providing services in a situaiton that can be literally life and death. The bottom line is that in the last six months, in the course of my normal daily work (the majority of my which is after 5pm) I have saved peoples lives. I have also been hit, called a b***ch and a c**t, threatened, and shouted at and harrassed over the state of the NHS generally all whilst trying to treat my patients to the very best of my ability.

That is the reality and it is different. If that's emotive so be it.

The issue of skiving, sickness "allowance" and back room take-it-easy attitude I really have no experience of. I'm happy to believe all those who say it goes on amongst non-clinical NHS staff and in the wider PS, but it doesn't amongst clinicians. I don't know how widespread it is, but I'm inclined to agree with Sean that it goes on everywhere and I really don't think it's the important issue here.

4. I don't know what exactly can be done, but as a starting point I would say better absence monitoring and structured reporting and return to work (a change that Loulou pointed out is already underway) both for monitoring and for early identification and support of staff with problems. It would also combat the problem of forced or early return to work (shown in the report to be associated with higher sickness). Better occupational health and treatment services for staff with injuries and illness would also help. It's the health service for goodness sake, it should be acheivable to treat our own sick and injured staff! The majority of NHS staff, although not PS staff overall, are female and there is a high proportion of carers amongst NHS staff, so better support for working parents and carers might also help. Most important it to overcome the culture of bullying and pressure within the NHS. As in any target based and stressful environment middle managerment are under huge pressure to conform to various measures and targets and all to often this pressure is transmitted to staff in negaitve and destructive ways. (what the expression? The f**cked kick downwards) That culture is changing, but slowly and better teaching of middle managers (clinicians inevitably find themselves in management roles as they become more senior without necessarily choosing to or being prepared for them) would help.

I'm conscious that my responses stick very much to the NHS side of the debate and I'm sorry if that frustrates anyone, but it's what I know and it's what I'm passionate about.

[Keef]

Anna I have to take you to task slightly here, as you seem to be doing your best to put a wide line of distinction between NHS, and all other public sector, and I think that is wrong and unfair. Of course everywhere is a bit different, including one heath trust from another. However, whenever Mrs Keef talks about her experience in the NHS, it rings very true of what I experience in social services, and what she experienced as a teacher. I disagree that the philosophy is particularly different in the NHS, based on my experience, which is of course, different from yours.

[annaj]

Keef, all valid points and there are lots of similarities and cross over between public services.

The only reason I was making the distinction so clearly and repeatedly was that earlier in this thread it caused aggrevation and misunderstanding when I was talking specifically about the NHS and others were talking about all PS.

What I was trying to express when I said that the NHS philosophy was different was the overall purpose and ethos of the NHS. The NHS is the only national, public organisation for the provision of specifically healthcare to the whole populaiton free at the point of contact. My point was not that it is better or worse than anything else just that, whatever anyone thinks of it, it is unique. And so whilst there are lots of related, similar and equally important areas it is actually very hard to make a valid direct comparison with anything else.

[Keef]

Fair enough, I just get defensive about social service stuff on here, as it's taken a few beatings, and I seem to be the only one from that world sticking up do it. Although I always like to point out that I am not a cardigan wearing social worker!

[Timster]

I know I'm arriving late in the day but I have read through a lot (if not quite all) of these posts and it is clear that people who work in the public sector are rightly protective of their reputation. The NHS (along with the BBC) is an easy target for alarmist newspaper headlines. Like the BBC it is an institution which should be the envy of the world. It would be nice if we all took a bit more pride in it.

But that is not the point of this post. If you look at the original article in the Times, it throws around numbers like 45,000 workers a day off sick and 10.3 million working days lost a year. These figures are meaningless out of context. The NHS employs 1.5m people in the UK. 45,000 off work a day is equivalent to 3% of the workforce. On the article's own figures, this compares with 2% of the workforce in the private sector. In other words, a more meaningful, but less shocking headline would be:

"3% of NHS workers off sick every day compared to 2% of workers in the private sector". Not very attention grabbing is it.

Actually, the Telegraph makes up its own maths on this, stating "1.4 million workers in the NHS, 4.5 per cent or 45,000 call in sick per day." Well, in my day 45,000 equalled 3.2% of 1.4 million. If the numbers don't sound shocking enough, just make them up!

The figures for numbers of days off are averages which means they are necessarily skewed by long-term absences. 10.7 or 6.4 sounds like quite a lot of sick days for an average person to take every year and that's because, in both the private and public sector, it will be far more sick days than are taken by the typical employee. The median figures (that is, if I am in a team of 8 and one of us is off for 3 months and the rest of us take 2 days sick a year, the average days off a year will be 9.5 whilst the median will be 2) will be lower and much closer together. So, in reality, the typical NHS employee maybe takes 2 more days off sick a year than the typical worker in the private sector. Given all the factors raised in the posts above that mitigate against NHS workers being particularly healthy specimens, this seems positively modest.

Also, half of NHS absences are down to muscular/skeletal (i.e. bad backs) type injuries, which will always require more than one or two days off. More importantly, you can work at a desk with a bad back, but not if your job involves lifting patients, saving lives etc. So there are bound to be more long-term absences skewing the figures for the NHS.

Anyway, I have to get out from behind my desk-jockey job (in the private sector) now. Hope this adds something to the debate.

[Huguenot]

Are you implying that the NHS has lots of people on long-term sick leave?

[SeanMacGabhann]

Nope - I read that as it has some people on very long-term sick leave

[macroban]

Shock! Horror!

The average number of sick days taken by a private worker is more that the median number of days taken by a NHS worker.

[Timster]

No that wasn't the point.

At the risk of repeating myself, if you compare the average number of sick days in the private and public sectors you will get a much wider variation between the two figures than if you compared the median number of days taken off by those two groups of workers. For example, take two groups of 20 workers. In the first group, they all take 2 days off a year except for one who is off for 6 months. In the second group, they all take 2 days off a year except one who is off for 3 months. The average days off are 9.1 and 5 respectively. The median figure for both is 2. If all you had to rely on was the average figures then you would assume that there was a huge difference between the amount of time off taken by a typical worker from each group - which, in fact, isn't the case.

That exaggerated variation which is caused by using averages is skewed further against the NHS because it has a much higher proportion of what are effectively manual workers compared with the private sector as a whole. Inevitably, people in a manual role are more likely to have accidents and be off for longer periods. It would be the same if you compared private sector factory workers with private sector office workers. Add into the mix the sort of stress levels that many NHS staff experience (which may be replicated in some parts of the private sector but are certainly not the norm in the private sector) and the figures are always going to come out higher for the NHS.

Having said all that, the point of the post was to demonstrate that the language used by the press, and the use of average statistics in the report, all served to exaggerate what is, in all likelihood, a relatively modest variation between the number off days of sick taken by a typical private sector worker compared to a typical NHS worker. If you told me you had taken 5 days off work last year when I had only taken 3, I wouldn't assume you were a skiver or had a work attendance issue. It's likely to be pretty much the same difference between a typical nurse and a typical lawyer.

Apologies if the maths is too patronising....

[macroban]

Of course it wasn't the point. It was a ~JOKE~!

The point is we can't do any analysis at all until someone presents some accurate private sector data. Until then we are all flailing.

[macroban]

I'm not giving these guys my personal details.

[Keef]

I thought Timster;s post was rather good.

[sophiesofa]

I also thought Timsters post was good. There's also a very small factor that most desk jobs allow you to work from home if you're feeling a bit crap.