Sickness at work: think “collective” first

As a support worker, I spend the vast majority of my contracted hours spent directly with vulnerable elderly patients. Most of this time is spent within arm’s length when delivering personal or supportive care.

So when they’re ill or if I’m ill, we’re likely to transmit germs.

The Covid-19 pandemic should have made us all a bit more aware of how flus and other diseases deadly for the elderly are spread from staff to patients. But now, with the hasty scrapping of monitoring and precautions, all practice of PPE, sickness absence and isolation when ill has been forcibly forgotten.

Managers ask us to come in “as long as you don’t feel too ill”, and there’s personal pressure to earn your wage (especially during probation periods without any sick pay) or to keep your hours up for your visa conditions.

But when staff are ill, if it’s not Covid, the decision on whether to come into work is solely based on the question: “do you, as a member of staff, feel capable of performing your job?”. There is no policy which advises staff against coming into work when they’re infectious. It’s the individual choice of the staff to choose whether to get paid and expose others or to feel guilty for letting the team down amidst chronic understaffing.

None of this process even acknowledges that staff coming in ill will make other staff ill and further understaff the service.

The responsibility of weighing up the consequences falls on the individual staff: who might get exposed to infection by me coming in, what about the effect on patients, what about knock-on staff illness? Even if I feel competent to start the day’s work, will I be able to complete my demanding job? What about fatigue and confusion affecting the day?

There seems to be little learnt in practice about the collective dimensions of disease which we started to talk about during the pandemic.

Individual staff take the blame. We are asked only about our ability to perform our job (not what the consequences are for others, or for our own recovery). The short term consequences for one shift are prioritised over the effects from illness spreading.

What could a collective-first approach to sickness look like? First, massive funding increases for frontline staff pay are necessary to increase the number in the workforce, creating extra capacity that can cope with illness fluctuations.

Secondly, all staff regardless of contracts should have sick pay from day one at full wages above the living wage. Thirdly, we need improvements to the built environment such as ventilation and airflow and convenient access to cleaning facilities.

Fourthly, provision for alterations in the type of work done as someone gently transitions back into their workplace (more admin duties over patient interactions). Fifthly, further understanding of the collective burden of health through workplace and societal education based on principles of public health planning.

We must remember what we all went through during the global pandemic, learn from the lessons and use them to transform our workplaces in the best interests of the workers and their patients. Those interests coincide in a broad overview.