How About a Sick Pay System That Doesn’t Make People Sicker?

Paltry payments mean many must work to the bone just to survive.

by Charlie Hertzog Young

28 November 2022

Cleaners clean empty office spaces
Four in five cleaners can’t access sick pay at all and 35% said they had worked while sick. Photo: Adobe Stock

“They wanted me to leave the job when I was ill,” said one cleaner, who was living in temporary accommodation at the time. Losing their job would have left them even more precarious: ill, broke and unable to pay rent. Calling in sick was simply not an option. Another person we spoke to put it succinctly: “without work, you can’t survive.”

The Centre for Progressive (CPC) change has spent the last year interviewing hundreds of cleaners across the country to find out how they’d like to see the UK’s sick pay system reformed. We chose cleaners because they are the workers most at risk of dying from coronavirus, having routinely worked through the pandemic in unsafe conditions – including cleaning up after lockdown parties in Downing Street. Four in five cleaners can’t access sick pay at all and 35% said they had worked while sick.

But the UK’s paltry sick pay system isn’t just a problem for cleaners, it’s a problem for everyone. It is a punitive incentive to work down to the bone, just to continue existing: an explicit tool of domination.  

In Europe, only Malta and Ireland have worse set-ups than us. The UK’s statutory sick pay (SSP) policy has been denounced by the Council of Europe as “manifestly inadequate”. It is an anachronistic and punitive system – and if we do nothing, Rishi Sunak’s incoming wave of austerity will soon make things even more dire.

Using the CPC’s research, the Safe Sick Pay campaign is calling for our current system to be reconstituted from the ground up. Now may be our best chance to do this, as the pandemic has forced the issue to the fore. Everyone is now powerfully aware of the primary importance of health and most have experienced firsthand the complex interactions between health and the economy. We can use that momentum to create change.

‘Without work, you can’t survive’. 

Those eligible for SSP are legally entitled to just £99.35 per week. That’s 19% of UK average pay, compared to 100%, 93%, 64% and 42% in Germany, Sweden, Belgium and Spain, respectively. Only employees earning above a certain amount are entitled to SSP, and even then only after four days of illness, despite 70% of UK sickness absences lasting 1-3 days. Then there are the four million self-employed workers in the UK who are not entitled to SSP at all. 

Our inadequate system means that when millions of people (including myself) are ill, they face a crossroads: a choice between losing financial security to make space for physical or mental recovery, and continuing to work despite an ailment. Both are fraught with risk, and both make people sick. 

Only 5% of cleaners are directly employed by a client and shifts are often split between employers, meaning most don’t qualify for SSP. But even those who do told the CPC they often feel forced to work when sick. As one person said: “They told us that if we got ill, they weren’t going to pay us, or they were going to sack us.” Another interviewee reported that they didn’t take sick leave “because they throw you out of work. They make the most of the government’s flexibility to be bad, firing you or reducing your hours.”

Our average sickness absence rate – the time workers take off sick – is half that of the rest of Europe. That might sound like a good thing, like we Brits are hardier than those on the continent. But research shows that inadequate social safety nets are driving people into work when sick; a recent survey in Wales found that two-thirds of workers went into work during bouts of illness. This phenomenon is called ‘presenteeism,’ and it’s on the rise in the UK. Presenteeism endangers people’s lives, especially when the sickness is contagious. Last year, presenteeism apparently cost the UK economy £92bn due to lost productivity (unsurprisingly, people don’t work well when they’re sick), equivalent to 38 days of work per employee because of mental and physical health problems.

A safe sick pay system.

Lots of meaningful proposals to change our sick pay system already exist, lots and lots. They almost unanimously agree on what to do. First, we need to raise the level of SSP payments to provide a genuine safety net, around £330 per week would be in line with the real living wage. Everyone deserves the freedom to recover in the knowledge that their livelihoods won’t be put at risk. Second, we need to remove the lower earnings limit and include the self-employed, zero-hours contracts and other insecure working arrangements in the scheme. If it’s not universal, it’s not just. Third, we need to remove the four-day waiting period. Finally, the government needs to provide targeted support for businesses and more strongly enforce SSP regulations. 

A safe sick pay system would have huge benefits. It would be in line with the NHS’s long-term plan of focusing on preventative care, rather than just treating symptoms and rarely getting to the root of the problem. It would increase the economic security of the country’s most precarious workers and constitute a shift towards a caring economy. The system would be affordable, too. The Resolution Foundation estimates that raising SSP to £330 per week would cost £3.8bn per year. To put that in context, the Exchequer currently loses around £30bn a year from lack of work due to ill-health. The most extensive macro-economic study to date found that, overall, more generous sick pay would deliver net economic benefits over and above the costs to government and business.

Our existing system is deeply rooted in neoliberalism and individualism, but also extractivism more widely. It’s racist, sexist, classist and ableist, riddled with power imbalances and structures of domination. We need to stop seeing people as disposable bodies and start treating each other with compassion and care. Creating a safe sick pay system would help give people the time and economic security to meaningfully recover from ill-health, avoid burnout and benefit physically and psychologically from knowing there’s a dependable system of support. All of this will shift us towards an economy and society where people are prioritised over profit. It’s not a silver bullet, but it’s an achievable, transformative place to start.

Charlie Hertzog Young is a researcher and writer, focusing on climate change, mental health and new economics.

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