SINGAPORE: Last week, Mohan Belani sent a company-wide announcement reminding his 30 employees that they do not have to produce a medical certificate (MC) from a doctor when they call in sick. “It’s a trust-based system,” he said.
“In most cases when people are sick, a large part is that they are either feeling burned out, or maybe they are tired from the previous day’s work. What they really need is some time off, a bit of rest and sometimes a quieter environment,” said the co-founder of start-up E27, Southeast Asia’s largest tech platform.
The company has had an honour sick leave system, as it is commonly known, since it started with three people in 2007, and has no plans of doing away with it.
“The other thing I also feel is that most people don’t like to go to the doctor,” Mr Belani said. “And getting an MC means having to go to the doctor, spending some money and so on. A lot of people are fine self-medicating or resting it out, which is fine with us.”
At least four other start-ups with 30 or more employees told Channel NewsAsia that they also have an honour system for sick leave. ViSenze, which develops visual search and recognition tools using Artificial Intelligence, has 45 full-time employees. It said staff need not produce an MC each time when they are too unwell to work.
Property portal 99.co’s CEO Darius Cheung said his employees also do not have to visit a doctor to get their sick leave certified. But the day does count towards their sick leave quota. E-commerce start-up, ShopBack, which has over 90 employees in Singapore, said staff can take sick leave without producing an MC “as long as their absence is communicated to their direct leads”.
EMPLOYEES ENTITLED TO PAID SICK LEAVE WHEN MC IS PRODUCED
While an honour system appears to be gaining momentum among start-ups, the procedures for claiming sick leave set out under the Ministry of Manpower’s (MOM) Employment Act are still widely practiced.
The MOM’s website states an employee covered under the act is entitled to paid sick leave if it has been certified by the “company’s doctor, a company-approved doctor or a government doctor”.
When news surfaced earlier this year of Singapore Airlines cabin crew voicing their unhappiness over the company’s medical leave system, the MOM issued a statement saying that employees should be excused from work if they have an MC as paid sick leave and hospitalisation leave is “a basic protection” under the Employment Act and a “core benefit in collective agreements”.
However, other countries adopt a different approach. For instance, in the UK, employees need to produce a “sick note” only after they have been off work for seven days. In fact, according to an official UK government website, doctors may charge a fee if an employee asks for an MC before the seventh day.
President of the Singapore Human Resources Institute Erman Tan said many companies do not feel the need to change what they feel has worked well for them. “They have their legacy, they have their existing system that people are comfortable with and that has worked well for their business model and where there is no need to change such a practice,” Mr Tan said.
Nonetheless, some organisations are testing the waters of a different approach. Singapore’s largest employer, the civil sector, implemented a system in 2013 which allows employees to call in sick for up to two days a year without certification from a doctor.
Bosch Singapore’s Senior Manager for Human Resources Jane Tham told Channel NewsAsia that the electronics and engineering company would pilot the same system for a year, starting in January. The company, which has 920 employees in Singapore, said there are no plans to implement specific checks and balances, “as the system is based on trust and the integrity of our employees”.
She said employees currently take an average of three to four days of medical sick leave each year.
Meanwhile, Cartus, which provides corporate relocation services for its clients, told Channel NewsAsia staff can take sick leave without an MC for up to a day at a time. But as a way of preventing staff from abusing the system, an MC is required if they call in sick on Mondays or Fridays, before or after a public holiday and before or after approved leave.
Cartus Asia’s Senior Vice President and General Manager Kenneth Kwek told Channel NewsAsia the company has had this system in Singapore for 15 years and it is also used in its other Asia Pacific offices. The company has more than 200 employees in Singapore.
“For common medical ailments such as a headache or common cold, employees might already have some medication on hand and all they need is probably a good rest, so they do not need to see a doctor just to obtain a medical certificate for submission to the company,” Mr Kwek said.
He added that if an employee is suspected to be abusing the system, the manager has the right to withdraw this privilege.
TRUST-BASED SICK LEAVE SYSTEM CAN WORK IN SINGAPORE: HR SPECIALIST
Experts say the fear of employees abusing the system seems to be a common concern that holds back local employers from exploring such options. Retired human resource specialist Amarjit Singh Wasan did some consultancy work for an SME with some 300 staff about four years ago.
He said one of the policies he encouraged senior management to take up was an honour system for sick leave. “Many of the things they followed but on the issue of leave, somehow they thought Singapore is different, that employees will abuse the system,” he said.
But Mr Wasan suggested such a system could work here. In 1998, when he was based in a nearby Southeast Asian country and working for an international organisation, an honour system was suggested. While he said he was initially skeptical, the programme was piloted for three years.
“The thinking was that maybe for certain very non-critical illnesses and simple illnesses like diarrhea, coughs and colds, headaches and other minor ailments, why not we do away with the necessity of having certified sick leave?”
Under the programme, staff could take up to three calendar days of sick leave without getting certification. But employees or their family members had to call up their supervisors beforehand. Mr Wasan said a report was also published every six months that detailed who had taken uncertified sick leave. He said supervisors also had the right to visit the employee at home, although this was hardly ever practiced.
“There was a little bump (in the amount of uncertified sick leave taken) initially for the first six months,” he said. “But within a year to a year and a half, it had corrected itself. In fact, further down the line, the actual sick leave record improved.”
Mr Wasan attributed those results to better accountability and higher morale among staff because the system showed them that the employer trusted them.
At the end of the pilot, the amount of sick leave being taken further declined. Other controls were added along the way, such as ensuring employees got certification if they had applied for annual leave and fell sick immediately before or after they went on leave.
“In any organisation, there will always be some percentage of employees that will abuse the system,” Mr Wasan said. “But for the overall good of everybody, we thought that this small percentage of abuse is too small for us to worry about.”
Mr Wasan said the savings to the organisation, as well as the benefits felt by the employees far outweighed “the small abuses” the company may have had.
DOES A CERTIFIED SICK LEAVE SYSTEM PREVENT ABUSE?
Advocates of an honour system like Mr Wasan and Mr Belani said even with the traditional system implemented by most companies, it’s not that difficult to get a day off from work by faking an illness to get an MC.
According to a survey conducted by online portal JobsCentral in 2012, almost 20 percent of some 3,300 Singapore employees admitted to faking an illness to get away from work.
Of this group, the survey said more than half took two days of “bogus sick leave” a year. All this despite the fact that about 78 per cent of the employers surveyed said they would check claims of being unwell.
Former teacher Jane* told Channel NewsAsia she would, on average, take sick leave twice a term, even when she was not ill. “Sometimes between classes and attending meetings, I would not have enough time to mark papers or plan lessons,” she said.
“I would fake an MC to stay home and finish the work. Other times, I’d just be exhausted during crunch time as we just were not getting enough sleep.”
Jane said she would alternate between her family’s general practitioner and the polyclinic so it would not raise suspicion. She often gave symptoms that were difficult to verify - such as diarrhea, giddiness and stomach cramps. After a while, she started telling her GP the truth - that she was exhausted and needed a day off from work.
“I think she might have already suspected because it was always those few things, but she never said anything nor refused to give me an MC,” Jane said.
“I did feel guilty faking an MC, because it would mean that the students don’t get their class for that day and it would be hard to make-up that lesson, at least not properly. But I also feel that if I had gone in anyway, the lesson would have been so ineffective that the students were better off with a free period for them to do their own work.”
Jane said she knows of other colleagues who also faked an illness to get an MC.
FAKING AN ILLNESS TO GET AN MC: CHANNEL NEWSASIA INVESTIGATES
A Google search on how to fake symptoms for an MC comes up with multiple online forums that share such tips. One Reddit user suggested giving the symptoms for a migraine, complete with nausea and “glittery vision”. Another suggested taking a long walk in the hot sun to get one’s temperature up before visiting the doctor. Some users at another forum discouraged members from visiting the polyclinic, as it was “more difficult” to get an MC.
To test this out, this reporter visited four GPs on a Friday - two in the East, one in central Singapore and one in the West. In each case, symptoms were described to the doctor that should have been verifiable with some physical evidence such as ear pain, a fever, a sore throat and a blocked nose.
All four GPs conducted a thorough examination and diagnosed an inflamed sore throat while two also found a bit of a blocked nose. One prescribed antibiotics, while the rest provided cough and cold medication.
One of the three GPs who had not prescribed antibiotics told this reporter that "toughing it out" would work as it was a viral infection, and would be okay with a lot of rest. “So technically I did not need to come to you had I not needed an MC to give to work?” this reporter asked. “Yes, although the medications I have given you will probably make you feel better a bit sooner,” he said.
All four issued an MC, with one giving an MC for Friday and the Monday after. This experience supported what GPs approached for this article were willing to say on the record.
“I AM NOT A LIE DETECTOR”: DOCTORS SAY MC SYSTEM STILL WORKS BUT ABUSE NEEDS TO BE WEEDED OUT BY HR
The GPs that Channel NewsAsia spoke to said they would give their patients the benefit of the doubt when they see such cases where it is not certain how bad the problem is.
“Some patients may not have the symptoms that fit a typical medical condition,” said Dr Alvin Ang, who runs a clinic in Tampines.
“Some doctors might think the patient is malingering but another doctor who is cognisant of conditions like depression might probe further and discover that the patient is actually suffering from that condition…not many patients at the onset tell the doctor they are depressed, or even realise that they are actually suffering from it.”
Another GP that Channel NewsAsia spoke with said he suspects about five percent of his patients could be faking their illness to get away from work. He has at some point refused a patient an MC when the issue of malingering is clear-cut, but usually gives even suspected fakers the certificate. “The doctors’ role is to always safeguard the interest of the patient,” he said.
Dr Ang agreed, saying it’s not fair to patients if the doctor always has to be doubtful of someone’s motives and that HR managers should not expect doctors to function like lie detectors.
Instead, Dr Ang said HR departments should have a better system in place for dealing with suspected malingerers within their organisation.
As to whether an honour system might work better in Singapore, Dr Ang said the current system serves its purpose well. “Yes, in other countries they have this (honour) system,” he said.
“But that’s because access to GPs is limited in those countries. It might take patients a few days to be able to get an appointment to see their GP. In Singapore, every housing estate has more than a handful of neighbourhood clinics. It’s not difficult to access a GP, where most have a walk-in system”
Instead Dr Ang said what should change is employers’ attitudes. He said some employers insist on only recognizing and accepting MCs from polyclinics.
“Their perception is that polyclinic doctors are more stringent when issuing MCs. But the polyclinics are already jam-packed with not just with acute but chronic patients. Patients who can otherwise easily see any other GPs in their neighbourhood, should not end up contributing to the queue at polyclinics, which are meant to serve patients who need subsidised care.”
BEYOND HONOUR SYSTEM, HR SHOULD CUSTOMISE POLICIES TO BENEFIT EMPLOYEES
While claiming there are benefits to an honour system, proponents of this approach said it will not take-off in all organisations. Mr Cheung and Mr Belani said companies need to have a culture of high ethics and trust in employees for the system to work.
HR expert Mr Tan said it might not work in industries such as manufacturing and food and beverage, where one’s physical presence is required. “Where team work is required then there must be minimum discipline because you are talking about staff rotation, staff duty roster and at the same time, a back-up system,” he said.
He said HR departments, whether in large or small organisations, should relook at their business model and the culture they are trying to cultivate. The department could implement different MC policies within the same company.
For example, having an honour system for the research and development arm of a company might be useful as employees would need more flexible, creative and innovative systems to thrive, instead of being “stifled by bureaucracy”.
In the same company, the manufacturing arm could instead benefit from another system. “Not necessarily an honour system but instead of taking sick leave, they could perhaps take a day off based on individual needs. Perhaps if they don’t feel like working they can call in and say ‘I need to have a day off because I’m not ready to work’,” Mr Tan said.
Mr Tan said with the economic environment changing rapidly, HR departments need to see how their “talent” is changing, and ensure they have the right policies to motivate and retain them.