In Sickness and in Health

There’s something called the Overton Window. Google it (other search engines, less cavalier with your data, are available).It’s a concept of what policies a government or a politician can propose (get away with) without appearing extreme or losing public support.

You can move it, and a lot of journalism is geared towards that end. Nudge theory is designed to do it as well. It’s not just about trying to get people to exercise more or get vaccinated without draconian legislation.

I have noticed its effects, particularly after events like the attacks on the Twin Towers when anti-terror legislation that would never have been countenanced before, swept away decades and in some cases centuries, of hard won civil liberties and rights in the West.

But this shoulder to the window, sliding the acceptable limits of interference in our lives is at work constantly. It normally moves so incrementally slowly, unlike the 11 September attacks, that we don’t notice it, and that is most of its attraction to those pushing it. Just occasionally something brings you up against its movement in a sudden harsh impact.

For reasons that needn’t concern us here, I’m not employed by anyone and have no reason to concern myself with whether I tell anyone I am too sick to work, I searched for ‘NHS advice on going to work when ill`.

This used to yield the advice from the NHS that you should not attend work with an infectious illness, cold, flu etc so as to avoid spreading sickness and causing more problems in the long run. Not now.

The first three pages were taken up with advice on rights in the face of pressure to work while sick, about NHS sickness policy towards staff (go to work), about how to return to work before your sick note ends, how returning to work is great for mental health issues, how you should….WORK!

Sick leave rates in the UK almost halved between 1993 and 2017 according to the Office for National statistics, from an average of 7.2 days to 4.1 days per worker.

Is this because medicine has improved dramatically? Because general social hygiene has soared to dizzying new heights? Or because there was a concerted effort by employers and government to scare workers back to work when ill? Presentism before Covid was at an all time high. Being there, being seen to be there, was vastly important. It didn’t matter you were inefficient and wrecked; ‘What a guy/gal! Showing up even when they were vomiting blood! That’s corporate loyalty!’

No it isn’t. It’s fear, because having created a caring society where the NHS could sensibly advise you to look after yourself and your fellow workers, people took the advice and stayed home when sick. Cost cutting measures with GPs led the government to say you didn’t need a certificate to authorise sick leave for the first seven days. So people were off work with no need to ‘prove it’. Employers went mad.

So the squeeze against ‘sickies’ was on. There was no actual evidence of the anecdotal misuse of self certification, but the idea was so strong that the whole issue got caught up in the fad for ‘metrics’. So averages were calculated and targets set. Think about that for a moment. How can you have a target for sickness? If the average was 7.2 days, some must have had more and others less. I have had years when I took way more than 7 days sickness. I had glandular fever as a 32 year old. It was horrible. I have also had years when I took no sick leave at all. But I still bumped into this insane obsession with driving down sick days rather than sickness, when I went over my ‘allotted’ number of self cert days one year and was asked to sign a document agreeing to take fewer days the next year. I refused. As I said I would be lying if I promised to do something I had no control over. At the time I was working in a job where a third of my year was spent flying and travelling overseas and the rest of the time travelling around the UK. I came into contact with all sorts of illnesses and sometimes they did infect me and I had to take a couple of days to recover. My boss said he had to say he’d tried. Instead of signing the paper I wrote a version of what I said in the previous sentences. I never heard another word.

But it is difficult to stand against bullying like that, and the rise of zero hours, and ‘flexible’ contracts designed to defeat workers’ rights legislation has eroded workers’ security and the ability to avail oneself of that protection that still exists.

The reduction in the number of sick days the average worker takes is trumpeted by many in government and employers organisations as a great battle won. And from the point of view of those trying to squeeze the last drop of blood from employees no doubt it is. But from the point of view of common sense, the health of the nation and the awareness of reality, it is a horror show. And the shifting of the Overton window that buries that still extant NHS advice to not go into work when ill, under a mountain of fear riddled Google returns about getting you back to work regardless of health, is a shaming indictment on us all. Not just those who pushed it for their own unscrupulous money grabbing ends but on the rest of us for not pushing back harder to protect those  rights so hard won by the welfare state that protected us all.

So when we nod at the bumbling rhetoric of a politician explaining that it is only reasonable in the short term to surrender our rights to do something because of the current emergency (whatever it is); stop. Stop and look who’s pushing that window of acceptability, where they are pushing it and what serious erosion of our liberties follows on that ‘reasonable’ request.

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