Marxism at Work - Sickness Absence Policies: Symptoms of a Sick System

Submitted by Off The Rails on 23 February, 2009 - 6:27

‘Capital takes no account of the health or length of life of the labourer, unless society forces it to do so. Its answer to the outcry about the physical and moral degradation, the premature deaths, the torture of over-work, is this: should this pain trouble us as it increases our pleasure (profit)?’
Karl Marx, Capital volume 1

The clampdown on sickness absence across our industry tells us a lot about how the capitalist system works.


Let’s take the idea of sickness as a ‘cost’. The employers, government, Health and Safety Executive and some union leaders all buy into this idea.
The CBI says that last year sickness ‘cost’ the economy £13.5bn. They get this figure from the fact that people took on average 6.7 days off sick and this amounted to £13.5bn in either sick pay or ‘lost’ production.

In this twisted view, the ‘cost’ of sickness is not the effect on your quality of life of being ill. Nor is it the human impact of workplace disease and injuries or the financial cost to society in looking after the millions of victims of these: a figure that dwarfs the ‘cost’ of sick days. For employers the ‘cost’ of sickness is simply the portion of the wage bill that the trade union movement has forced them to pay to ‘unproductive’ workers in sick pay.

The government decision in 1994 to remove the right of employers to claim back most Statutory Sick Pay payments spurred the interest in reducing sickness absence rates. Since then, employers have reduced absence rates by 20% across industry.


People get sick. Colds, flu and other infections are part of life. They are made worse by over-work, stress and tiredness. More serious illness is also part of the human condition. If work was organised on a rational basis by the producers ourselves, we would plan things properly with slack built into the system (remember spare turns?) and more genuine multi-skilling. This would ensure that people would have their work covered and have time to recover properly from sickness and to return to work on a basis that worked.

But we have the opposite of rational planning: an irrational system operating only short-term and on the basis of screwing as much as possible out of the working class. This leads to ‘presenteeism’: people going to work when they are ill spreading infections to others and slowing down their own recovery. Policies allegedly designed to get people back to work have the opposite effect as they spread disease and increase absence. Sick people do not operate at their best; driving them back to work early lowers productivity and increases risk of workplace injury.

Long-term, ‘presenteeism’ makes workers feel under-valued, worthless cogs in a machine with no choice. This worthless feeling is linked to under-productivity, apathy and unprofessionalism. So coming to work ill benefits neither worker or employer. So why do employers pressure us into doing so?


A recent TUC poll found that ‘more than half the workforce have gone to work when too ill during the last year. Only one in eight (12%) say they have never gone to work when ill.’ This trend is on the increase: ‘in 2004 ... one in four (25 per cent), said they had never been to work when too ill.’

The main reason given for coming to work when ill was understaffing and unwillingness to leave workmates in the lurch (49%). Also cited were management expectations (18%), loss of pay or fear of discipline (19%). This shows that ‘lean production’ and tough sickness policies go hand-in-hand in getting people to work when they should be at home recovering. The slump has increased fear at work and 29% say they are now more likely to go to work when sick than a year ago.

This is underlined by employers dealing with sickness absence as a disciplinary issue at all - as though being sick is being naughty.


Recent academic studies in the US question whether the cost in management time of sickness absence disciplinary policies is justified by gains for employers in reducing sick pay. They conclude the policies are cost neutral.

The true value of tough sickness regimes to employers is not in saving sick pay. It is the fear generated in workers’ minds and the power this gives to managers.

Management will continue to ‘improve’ their sickness absence policies in order to tighten the screw on workers.

Transport workers have the best attendance record in the country (the Office of National Statistics found that 0.8% of us had been off sick during a given week compared to a national average of 2.5%), but management will take their harsh policies further and further if we do not call a halt.

Sickness absence policies are about giving bullying managers power over workers and instilling fear at work. They are symptoms of a sick system and proof that as Marx said, for capitalism the workers’ pain does not trouble it so long as it increases their profit.

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