Long term sickness absence

Editor—A great deal of sickness absence, as mentioned in the article by Henderson et al,¹ arises from the worrying trend to medicalise life. Much absence due to work related stress is in fact disaffection rather than disease. It manifests itself as unhappiness and anxiety with the working environment and becomes a withdrawal from work legitimised as a medical problem through certified absence.

Most healthy people of average fortitude who are given work that is interesting, satisfying, properly resourced, and professionally managed will turn up to do it. There is abundant evidence that such work is good for long term health. The reverse is also true. The common belief held by bad employers and some politicians that people are naturally work shy is an urban myth.

We need better management rather than better medicine. Good occupational physicians should use their influence to encourage good management in their own organisations, to make sure that stress risks are systematically and professionally assessed and be at the heart of rehabilitation in concert with the general practitioner. Good general practitioners will work with us to get their patients back to work.

With an ageing workforce and a difficult and rigorous pensions climate we are all going to be at work for much longer than before. Long term incapacity due to stress and early retirements, often on tiny pensions, are not sustainable options for the economy, pension funds, the NHS, or the future.

We have warehouses full of research and policies all saying the same things. What we now need is action on behalf of employers who believe that decency in the workplace makes good health and therefore business sense matched with action by doctors who believe that work should be part of their patients' solution, not their problem.