Depending on whom you talk to, Britain's 2.7 million long-term sick - the number registered as claiming incapacity benefit (IB) - are not really sick at all. According to work and pensions secretary James Purnell, 60% of claimants could easily be reintegrated into the workforce and, for the past few years, reducing the number becoming sick (it has risen from 1.8 million when Labour came to power) has been a political hot potato as government struggles to address skills shortages.
For employers forced to deal with the impact of genuine, long-term illness, the temptation to conspire with sick-note-happy doctors is well documented. The CIPD recently interviewed 750 employers and found 43% thought former IB claimants would be less productive, with 60% worried they would be more prone to absence. Only 3% actively target the long-term sick in their recruitment strategy.
Which is why HR magazine is launching an initiative (see p9) which recognises organisations that are going beyond the call of duty in supporting, and taking a non-discriminatory approach to staff who have had, or are still overcoming, various major health setbacks.
"At last, it seems we are finally seeing some changes in employers' views," says Mark Moorton, engagement director at healthcare insurer AXA PPP Healthcare. "Enlightened employers no longer consider employees as a throwaway commodity; skills shortages have made them stop and think about how they can be more flexible and accommodating. If that includes staff on long-term absence through illness, then they have to cater for that."
Yet, while Michael O'Donnell, chief medical officer at disability insurer Unum, agrees that good practice is spreading, he argues that larger employers are still not as forward-looking in this area as smaller employers. "The motivation for dealing with the sick seems to be greater when the people at the top are close to those at the bottom," he says.
O'Donnell also feels employers have totally unfounded fears or ideas about long-term sickness. "Someone returning to work after a stroke, for instance, might fear work itself could be harmful. These concerns are often exaggerated with people asking questions such as: 'Will he/she cope with the stress of work again?' We ask instead: 'What about the stress of not working?'." He adds: "Similarly, with cancer, for example, employers do not always realise how much prognoses have improved recently. In many cases, even if a cancer is not cured, it is only a chronic disease - with long life expectancy."
The minority that do support staff are the evangelists. WPA, a not-for-profit medical insurer, has recently launched a policy to pay for cancer drugs denied by the NHS. WPA spokesman Charlie MacEwan says take-up has been so great that WPA launched another product to at least tempt previously disinterested companies into action: "It's called Health Top Up Plan," he says. "It is aimed at companies that do not want to pay for full medical insurance but who want to do something to make their employees' NHS care more comfortable."
Knowing where to start with the long-term sick is often cited as a barrier to companies tackling this issue. Ben Willmott, employee relations adviser at the CIPD, argues that the most effective approach to take to long-term sickness is to provide occupational health cover, access to flexible working hours (to accommodate follow-up treatments or check-ups) and phased return-to-work policies. "You also need dedicated rehabilitation and return-to-work support for individuals, such as a case management approach where, as an organisation, you have someone taking responsibility for that individual's return to work."
But who is already doing this - and more? Here we profile two companies - BT and MRC - that do not treat sickness as a life sentence.
BT'S RETURN-TO-WORK POLICY
Three-quarters of all BT's long-term absentees return to work - against a national average of 20%-25%.
"BT sees maintenance of good mental health for all employees as a priority," explains people and policy manager Sally Ward. "Over the past five years, we've cut our mental health sickness rate by 30% because we've worked hard with staff to provide them with a framework.
"For instance, lots of people think that because someone is off sick with mental illness, then the line manager must not contact them. But by Martha Wiseman's line manager keeping her up to date regularly in a very relaxed way, it was easier for her to come back to the workplace.
"We don't want people to come back until they are ready. But it's in both parties' interest to get a member of staff back to work. As a business, we make an investment in the individual. We don't want to see that investment go to waste."
MARTHA WISEMAN, BT
Martha Wiseman is carefully reviewing her notes for the next day's event. A business consultant at BT for the past 20 years, she is scheduled to speak at a conference about her experience of long-term absence from work. In 2004, Wiseman, 48, had to take 18 months off with clinical depression. And with her employer's help, she returned to work full-time two years ago.
"Other companies can learn a lot from BT," she says. "Long-term absence is often seen as a drain on the bottom line. But keeping people who've been off sick long-term is well worth it."
Four years ago, Wiseman found herself in a very stressful situation. An only child, she was trying to juggle her full-time work at BT while caring for her elderly mother, who has dementia. "It was a struggle to balance it all even though she lives 10 minutes away. Then she fell and broke her hip. So I was managing work with visiting her in hospital - an hour's journey. By then, I was so stressed. I hadn't slept properly for weeks. In the end, I thought: 'I can't do this.' Things had gotten much worse than I thought."
Wiseman had gone from very stressed to something much more serious: clinical depression. "I couldn't function at all," she recalls. "I couldn't even get out of bed. My GP signed me off work and I went on a list for NHS counselling. But I was terribly worried about work."
Her worries were groundless. Right from the start, Wiseman's line manager arranged to see her each month. "It was a structured meeting and he'd tell me what was going on," she explains. "But he didn't attempt to probe or give me a pep talk.
"So I felt I was still in the loop," she adds. "At first, it was hard to turn up. I withdrew from everyone, friends, colleagues, even family. I was so depleted. But as time went by it got easier. And my line manager could see I was changing month by month."
Regular GP visits, fortnightly counselling from an NHS clinical psychologist, acupuncture for insomnia and that crucial support from her employer gradually helped Wiseman overcome her illness. She also saw an occupational health specialist (a service provided by BT) three times.
Eventually, she started work again. "I did one day a week for a couple of weeks. A continuity development manager oversaw my return to work, starting me off with relatively small assignments until I was used to working again full-time.
"I work differently now," she explains. "I'm in a long-term role - learning and development analysis and consultancy around training programmes. My mum will deteriorate over time, but I can still help her: BT is supportive there too. People don't realise how many face this kind of situation at home."
She feels there is a huge stigma around employees recovering from mental illness. "People in this situation are the walking wounded," she points out. "But seeing people come back well from long-term sickness is good for overall morale."
IAN HALLIWELL, MRC
Ian Halliwell strides into his office at MRC International Recruitment, cheerfully greeted by his colleagues. As chairman of the board, he works at the Chester office one day a week and at its Shrewsbury branch on another day. The third day of his working week will be spent working from home in Wigan.
It is a far cry from the accountant's once-frenetic working schedule: 100 hours a week, seven days a week. For 10 years Halliwell, now 50, had a full-time post as MRC's finance director. He rarely stopped travelling and working. But that all changed dramatically in December 2006 when Halliwell collapsed on the office floor - with a stroke.
"No doubt my workload had a big impact on what happened," he admits. "I didn't even know I had high blood pressure. Thankfully, one of the managers, Lisa Burke, recognised the symptoms. It was her quick thinking that got me into hospital."
The medical verdict did not look good at first. Halliwell was totally paralysed down his left side. Doctors told his wife, Karen, it would be touch-and-go for at least two weeks. "They were worried I'd have a heart attack but thankfully that didn't happen," he says.
Halliwell remained in hospital for nearly five months. He needed intense physiotherapy to get him back on his feet, although fortunately his speech was not affected. But when he went home in April 2007 it was clear that dramatic changes needed to be made to his punishing lifestyle. Yet how would his employers react?
"MRC covered my salary. They were totally supportive. At one stage it looked as if I might have to leave - but they never suggested it," he says. "MRC suggested I work three days a week as chairman, comprising a more managerial role over our senior people. Effectively it was a promotion."
Halliwell started his three-day working week in August 2007. "I can keep the company car for personal use but I travel to work by train now - it's much less stressful."
Everything in his life has changed. He now spends two to three months a year in Florida and does fundraising for the Stroke Association. But one important consequence of his brush with death has been the way MRC views long-term illness.
"They've brought in 'death in service', critical illness cover and Bupa health insurance for all senior staff. It's put 2% on the salary bill but the benefit is higher staff retention. And we're offering a free will service to all staff so our HR department has some personal information on file, if the worst happens."
He is, he feels, doubly fortunate to have recovered so well and to have such supportive employers. "Other companies could do a lot more to pre-empt long-term illness. You need to be constantly alert to health issues - whatever the size of the company."
A WAKE-UP CALL FOR MRC
When someone as senior as Ian Halliwell is taken out of the business at short notice, it leaves a major hole. "The main problem for us, initially, was picking up the pieces during Ian's illness," says David Ward, marketing and IT director at MRC International Recruitment Group, which employs 32 staff in seven offices. "Obviously, given Ian's condition, there couldn't be a handover and that was very difficult. We picked up, very quickly, just how big his workload was."
As a result MRC identified some failings in its reporting structures and has introduced a new approach to dealing with illness.
"We've implemented more detailed reporting, so we know what everyone here is doing," explains Ward. "And as a company we now believe health insurance for senior staff is money worth spending."
- Strokes are the UK's third biggest killer, so help raise vital funds for The Stroke Association by taking part in Siemens' Stroke for Stroke week and rowing a sponsored 10km at your local gym. Stroke for Stroke Week runs from October 27-2 November. To find out more and sign up to receive a free pass to LA Fitness Gyms, go to www.siemens.co.uk/strokeforstroke.