For a country that Rishi Sunak has accused of having a “sick note culture” and has previously been derided by Conservative ministers as a nation full of slackers, Britons actually do go to work quite often when they’re feeling unwell.
Forget the stereotype of the sick person sitting in front of the TV or enjoying the sun. Much more striking is the image of someone sneezing and coughing in the workplace.
Analysis published this week by the Institute for Public Policy Research (IPPR) has found that the cost of presenteeism – working while ill – rose by £25 billion in the UK last year compared with 2018. It builds on previous research suggesting that presenteeism is a much bigger problem than absenteeism – people being ill – with the UK consistently ranking high for the former among European countries.
Sir Cary Cooper, professor of organisational psychology and health at the University of Manchester’s business school, said he coined the term presenteeism in the 1980s.
“A journalist called me and said, ‘Cary, I look at the numbers and we’re in the middle of a recession and absenteeism is down. How can that be when people are losing their jobs, feeling insecure about their jobs, getting sick from worrying?’ I said, ‘Well, would you want to have your sick day on your HR file? You’re going to show up to work sick just to show how you’re doing.’ So I think we have that context now in a way.”
Insecure work is now a widely recognised cause of presenteeism, but there are others. Cooper said there were also people turning up sick who didn’t want to create extra work for colleagues and “thought they were being nice”.
Rachel Suff, wellbeing adviser at the CIPD, the professional body for HR and workforce development, said that workload was also a contributing factor to sickness absence, as was management culture. Many companies operate a system where someone who is off sick three times in a given period is given a warning.
Andrew Bryce, a researcher at the University of Sheffield and co-author of a 2022 paper on presenteeism, said the increase is also due to poor health, particularly mental health, on the rise.
The costs of presenteeism cited by the IPPR include the impact on individual productivity and recovery time from short-term illness, making poor work decisions and making colleagues ill – known as ‘contagious presenteeism’.
You might expect that protocols for coming into the workplace when allowed during the coronavirus crisis – from telling people not to come if in doubt to on-site temperature checks – would bring about lasting culture change, but experts said it wasn’t that simple.
“A lot of people were working from home during the pandemic and so people who had Covid didn’t necessarily take time off, they just worked from home,” Bryce said. “Boris Johnson didn’t stop working when he got Covid (initially). He stayed on as prime minister while he was seriously ill. What kind of example did that set for the rest of the population?”
Cooper said “many employers are trying to go back to the old way”, meaning they are abandoning hybrid and flexible working practices introduced during the pandemic, which were better for people’s health and productivity. He said there was room for optimism as many companies were monitoring presentism and there was a culture change among younger workers.
“The good news — and it’s good news for our economy — is that this generation is not going to tolerate bad work, and by bad work I mean a culture that demands a kind of presentism,” Cooper said. While he cited his MBA students who refused to work for certain investment banks, he acknowledged that they were in a very different position than “very vulnerable” workers.
The IPPR Report found that people with the lowest education level, lowest income, less specialized occupations and an ethnic minority background were more likely to continue working while ill.
Suff said an ageing workforce could lead to more presenteeism, but highlighted as positive developments Labour’s proposals to scrap the three-day waiting period and lower the earnings threshold for claiming statutory sick pay. She said she believed arguments that it would result in more sickness absence were misplaced in light of what we know about presenteeism. “We would have a much more optimistic view of people and their attitudes and relationships to work,” she said.