Danish government turns to doctors to tackle rising absenteeism from work

BMJ 2008; 336 doi: (Published 24 April 2008) Cite this as: BMJ 2008;336:908
  1. Ned Stafford
  1. 1Hamburg

    The Danish government is concerned about an increase in the number of employees who are missing work because of illness. It has enlisted the help of the Danish Medical Association to devise a plan to help keep people working and to cut disability payments.

    A recent study coordinated by the Danish Ministry of Employment calculated that the national cost of missed work because of illness in wages and sick benefits in 2006 was 37bn Danish kroner (£4bn; €5bn; $8bn), or about 2.3% of gross domestic product. Particularly worrisome is the finding that the number of people who take at least 14 weeks’ sick leave rose by 25% in 2007 compared with 2005.

    Jens Winther Jensen, president of the Danish Medical Association, told the BMJ that the vibrant Danish economy is facing a labour shortage and that he had discussed the matter with Claus Hjort Frederiksen, the employment minister.

    “We have to be more active in Denmark in trying to get people back to work,” he said. A specific action plan has not yet been finalised, but Dr Frederiksen says that doctors might be encouraged to define more specifically what sort of work patients on longer term sick leave are capable of or whether part time work would be possible. “We think this would benefit patients and society,” said Dr Frederiksen.

    He added that he would like to see a change in Danish law so that doctors would no longer have to provide statements for employers who demand certification for employees who are sick for just a few days.

    “I do not want to be a policeman for employers,” said Dr Frederiksen, adding that the doctor-patient relationship demands trust. But, he said, when patients are sick for longer than a week or two “that is the point where we want to be active as doctors.”

    Helle Osmer Clausen, the head of the division of analysis at the Ministry of Employment, said, “The Ministry of Employment has no knowledge of whether doctors are too generous or not in issuing [sick] declarations. However, our focus is on having the declarations declare what job tasks . . . the person in question may be able to perform.”

    In June the government will issue specific proposals for reducing sick days, she said.

    Although the government is focusing on reducing longer term sick leave, the total daily absenteeism rate in Denmark is high, with about 5.4% of the workforce absent each day because of illness, up from 5.1% in 2001. That compares with a daily absenteeism rate of 2.7% in the United Kingdom in the winter of 2005, the most recent data available. In Germany the rate has dropped steadily in recent years, sliding to 3.4% in the first quarter of 2008.

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