Irish people "tend to be very good about going to work when they are sick", the Oireachtas special committee on the State's response to the Covid-19 crisis heard last week.
“We have that complex whereby we feel we cannot call in sick or stay at home,” Dr Cillian De Gascun told the committee as it discussed how to prevent a second wave of infections as the economy opens up and people go back to work.
De Gascun, director of the National Virus Reference Laboratory, said it was “really important” to get across the message that employees who feel unwell should avoid the workplace.
“If people have respiratory symptoms for whatever reason, they need to stay at home in the coming flu seasons because if they are going to work while coughing and sneezing, they are transmitting something.”
But how many Irish workers are motivated to show up to work sick, no matter what, because they fear the financial consequences if they don’t?
While this pandemic has underscored the particular vulnerability of gig economy workers, contractors and the self-employed across many sectors, hundreds of thousands of private sector workers – including those in permanent employment – have long faced a cliff-edge drop in their incomes when they fall ill.
This is because there is no statutory obligation on employers to provide sick pay, while the State’s illness benefit payment will only replace a low percentage of regular pay for many.
As soon as coronavirus struck, and the Government grew conscious of the serious public health risk of sick people going to work and infecting others, it announced an improved rate of illness benefit – but only for those with suspected or diagnosed Covid-19 who are told to self-isolate by their doctor or the Health Service Executive (HSE).
For people suffering from other conditions, the old rules still apply. And if they receive no sick pay from their employer, illness benefit may be the only help they can get.
Illness benefit rules
There are two main differences between the State’s illness benefit payment and the enhanced illness benefit paid out to those who either have Covid-19 or are told to self-isolate as a result of close contact with a suspected or confirmed case. These differences relate to the rate of payment and the “waiting days” before the payment kicks in.
Normally, illness benefit is paid at a rate of €203 a week, or less if the recipient’s average earnings before getting sick were less than €300. For most people there will be a six-day waiting period, meaning they will have to go out sick for this long before they become eligible for the payment (the exception to this relates to people in receipt of certain other social welfare payments).
To qualify for illness benefit, the recipient must be under the age of 66 and meet certain Pay Related Social Insurance (PRSI) conditions, including the payment of at least 104 weeks of PRSI since they first started work. Self-employed people can’t get illness benefit, but if they have a long-term condition that prevents them from working, they may become eligible for the State’s invalidity pension. People over the age of 66 do not pay PRSI but will have done so in the past. However, they are not eligible for the benefit.
For the Covid-19 enhanced illness benefit, the personal rate of payment is €350, as opposed to €203. The crisis rate was initially set at €305, but was then brought up in line with the rate paid out to people who lose their jobs or income as a result of the economic shutdown.
Both employees and the self-employed can access the Covid payment, with no specific social insurance record necessary, and crucially no six-day waiting period applies.
As Taoiseach Leo Varadkar put it, the objective here is that workers aren't "afraid to follow advice to self-isolate due to economic necessity". Before the Government's intervention, the Irish Congress of Trade Unions general secretary Patricia King had warned that, because there was no statutory entitlement to be paid by an employer for absences from work, many workers wouldn't be able to afford to follow HSE advice to self-isolate.
As of June 8th, some 48,900 people had been certified to receive the Covid-19 enhanced illness benefit. According to the Department of Employment Affairs and Social Protection, this number “predominantly” relates to applications made by people advised by their GP to self-isolate, with “a smaller number” of applications made by people diagnosed with Covid-19.
In several EU member states, the rate of payments increases in line with workers' salaries and sick pay is treated as part of their compensation package
Standard illness benefit is paid out up to a maximum of two years, at which point somebody who cannot work may be eligible for the invalidity pension payment. Under the current rules for the Covid-19 enhanced illness benefit, however, the €350 payment is only made for a maximum of 10 weeks if the person has the disease – potentially a tight timeframe in cases where people are struggling to fully recover from it – and a maximum of two weeks in cases where the recipient has been told to self-isolate because a close contact or someone in their household has it.
The payments are for people who cannot and do not work. It may be feasible to work from home while self-isolating on a precautionary basis, but if your employer is paying you to do this, you cannot also receive the two-week enhanced illness benefit.
International comparisons
The obvious question that has been posed by the pandemic is this: if an illness benefit rate of €203 a week that is only paid out after the first six days of absence was deemed insufficient to stop suspected cases from showing up to work and potentially infecting others, does the rate of €350 a week with no waiting period provide enough of a financial safety net?
Michael Taft, researcher at trade union Siptu, says the State's approach to illness benefit is not really a proper system of social protection by European standards. In several EU member states, the rate of payments increases in line with workers' salaries and sick pay is treated as part of their compensation package, along with base pay and pension.
"In Ireland, if you're sick for a month and your employer has no sick pay, you have to wait six days to get illness benefit. That's a week lost in pay. Then when you get it, it maybe only covers about 25 per cent of your normal pay. For a lot of people, it's too much of a financial strain."
Indeed, even the €50-€60 consultation with a GP in order to secure the necessary medical certificate may be off-putting to some employees, who may instead choose to struggle through at work, at a risk to their own health and that of others.
The improved Covid-19 rate of €350 a week, “sounds like a lot, and it is compared to €203”, he notes, “but for someone on the average wage, it is still less than half of what they earned before”.
The Irish system is certainly strikingly more perilous compared to those across Europe, comparison data from Glassdoor HR shows. In Germany, employers must pay sick pay at a rate of 100 per cent of the workers' earnings for the first six weeks, with a national health insurance fund stepping in to compensate smaller employers for most of this cost.
After six weeks, the fund pays the worker 70 per cent of their pay for up to a further 70 weeks.
In Denmark and Finland, ill workers will also be paid 100 per cent of their usual pay for 52 weeks and 43 weeks respectively, while, in Belgium, workers can typically avail of full pay up to 30 days, and then 60 per cent of pay for up to a year.
Sweden, the Netherlands, Austria and France also have substantially better illness protections than the Republic.
“Whether we will learn lessons from this crisis is doubtful, because it would require quite a systemic change,” says Taft. Increasing the sums payable through the State’s illness benefit, for example, would most likely be financed through an increase in the rate of employers’ PRSI, a move that would be fiercely resisted by business groups.
Taft predicts that the enhanced €350 payment will eventually fall back, but that Covid-19 cases won’t be subjected to the six-day waiting period.
The situation is less than ideal for middle-income earners in the €30,000-€60,000 salary range. For these households, the relative lack of social protection means that when illness strikes, the financial impact can be dramatic.
Employers' groups have argued that it is the State... that should step in and provide the sort of safety net many companies can't afford
“If you’re on a high income, then you probably have some savings. If you are on a lower income, then at least the replacement ratio is better,” says Taft.
But if Covid-19 has proven anything, it is how it is in no one’s interest when infectious people are compelled by financial necessity to clock in as normal and somehow get through the day. A culture of workplace presenteeism is a public health issue that, one way or another, affects us all.
Employer sick pay schemes
In the public sector, workers can avail of up to seven days uncertified paid sick leave over a two-year rolling period under a standardised public sector scheme introduced in 2014.
For most, this represented a cut in their uncertified paid leave from seven days a year, while the periods of full pay and half-pay for certified non-critical illnesses were also effectively halved to three months each in a four-year period.
Little data is publicly available on how many private companies have paid sick leave policies as a matter of course. Unionised workforces in larger companies, including the major retailers that found themselves on the Covid-19 frontline, will be more likely to have access to some sick level of sick pay, though it is in sectors such as finance, technology and high-end manufacturing where 100 per cent pay replacement schemes tend to be found.
Siptu has estimated that more than half of private sector employees have no occupational sick pay and will instead be directed by their employer to apply for illness benefit.
While unions say the onus to protect workers shouldn’t fall entirely on the State, employers’ groups have argued – both in the past and at the outset of this crisis – that it is the State that should step in and provide the sort of safety net many companies can’t afford.
But if anything, before Covid-19, the State had been hardening its attitude to sick pay. In 2014, the number of waiting days before illness benefit kicks in doubled from three days to six, a measure that was projected at the time to save the exchequer an annual €22 million.
