Self-declare sick leave: a controversial proposal

In a critical report on the policy of combating medical deserts, published Monday, the Court of Auditors suggests "exploring" the avenue of self-declaration, already implemented in several countries also facing shortages of doctors.

Questioned Tuesday morning on TF1, the Minister for Health Frédéric Valletoux said he wanted to “open (this subject) with employers”. “We must, with the employer networks, discuss the feasibility of this measure, which would free up medical time,” he declared.

For the Sages of rue Cambon, the measure would imply the establishment of one or two days of absence which could not be compensated. Currently, the first three days of sick leave are not compensated by health insurance, but are covered by a majority of companies (61%, according to a 2015 Drees study).

“We are not in favor of it,” we told Medef. For the employers' organization, sick leave "must remain based on a medical justification" and "it is a bad answer to the question of the lack of doctors".

“It can be done but not without safeguards”, believes for his part the vice-president of the confederation of SMEs (CPME), Eric Chevée. His organization wants the establishment of three public order waiting days, that is to say compensable neither by health insurance, nor by company mutual insurance or the employer.

The CPME would also like to establish an annual cap of seven days for self-declared stops and prevent them from allowing the acquisition of paid leave. Finally, the measure should only be temporary, until the shortage of doctors in France is resolved.

The self-declaration would prepare "a transfer to the company of the control of sick leave of its own employees", judges the vice-president of the National Association of Human Resources Directors (ANDRH) Benoît Serre. This is not the type of relationship a company wants to have with its employees, he says, seeing it as a form of “relationship of suspicion”.

"Danger"

The proposal is also rejected by the unions.

A sick leave "is a medical procedure which requires an exchange with a doctor", which can possibly "be done by video to overcome the difficulties linked to medical deserts", reacts Isabelle Mercier for the CFDT. The first union would protest “against any increase in the waiting period, which is unfair and harms the most vulnerable”.

Eric Gautron for FO "fears that this +confidence+ granted to the patient by a self-declaration will be counterbalanced, or even +exchanged+, against an extension of the waiting days".

“This will increase suspicion” against employees on sick leave, fears Cyril Chabanier, the president of the CFTC. “This can even lead to endangering people who do not see a doctor, underestimating their state of health,” according to Denis Gravouil of the CGT.

Benoît Serre of ANDRH instead recommends "the extension of those who can deliver short work stoppages, such as nurses or pharmacists".

The self-declaration proposal, on the other hand, is favored by the union of young general practitioners Reagjir. “The fight against unnecessary consultations for purely administrative reasons is undoubtedly a major lever for promoting access to care,” he said, calling for examples from other European countries.

In the United Kingdom, the self-certification procedure for stops of less than seven days, generalized in 1985, is today "used routinely" via a simple form to complete, the employee "can be paid for his days absence beyond three days", observes the Court of Auditors in its report.

In addition to saving medical time, the government is looking for savings to try to control the strong growth in expenses linked to sick leave, which weighs nearly 16 billion euros per year.