SINGAPORE: New Nominated Member of Parliament (NMP) Irene Quay on Tuesday (Nov 20) called on the Government to encourage employers to allow their employees to take up to three days of non-consecutive sick leave each year without submitting medical certificates (MCs), saying that the move could help build trust and boost morale.
Speaking in Parliament, Ms Quay - who is also president of the Pharmaceutical Society of Singapore - said that individuals who queue at clinics to get an MC for common ailments such as the flu might inadvertently end up infecting others.
"Apart from being unproductive and potentially spreading your contagion, being out and about would actually exacerbate your illness when you should be getting much-needed rest at home," she said.
"One may even conveniently ask for unwarranted antibiotics since they are already at the clinic, contributing to global antimicrobial resistance problems."
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Ms Quay was speaking on the Employment (Amendment) Bill, which will require employers to recognise MCs from all doctors. Currently, employers are required to accord paid sick leave only if the MC is issued by Government and company-appointed doctors.
"Today, doctors are registered under the Medical Registration Act and are subject to the Singapore Medical Council Ethical Code and Ethical Guidelines," Manpower Minister Josephine Teo said. "Therefore, there is no longer a need to distinguish between MCs issued by different groups of doctors where paid sick leave is concerned."
Taking it a step further to allow sick leave without an MC, said Ms Quay, will reflect "a strong signal of trust" between employers and employees, and in turn increase accountability and morale.
While Ms Quay admitted that there will always be a "small percentage" of individuals who will abuse the system, the benefits would outweigh the "small number of abuse cases".
Ms Quay proposed audits and provisions as methods to prevent abuse, and a surveillance system to look out for cluster infections.
"In fact, even with our current situation, it is not difficult to get a day off from work by faking an illness to get an MC," said Ms Quay, citing a 2012 Jobs Central survey that showed almost one-fifth of 3,300 Singapore employees admitting to having faked an illness to get away from work.
Ms Quay also noted how several healthcare clusters and civil service organisations have already been allowing their employees to take sick leave without MC "for many years", and that the Employment Act also does not prohibit employers from doing so.
"But there is a need for MOM to mandate it in the Act so that these benefits can be accelerated across the nation, rather than to let nature take its course," she said.
In response, Mrs Teo said that creating controls and audit systems to prevent the system from being abused would add to business costs.
"As the Employment Act does not prohibit employers from (according sick leave without MCs), progressive companies are free to go ahead to offer this as part of their talent attraction and retention strategies," she added.
CAN NON-DOCTORS ISSUE MCs?
As for the amendment requiring employers to recognise MCs from all doctors, Ms Quay asked the MOM and Ministry of Health (MOH) to consider allowing Collaborative Practice Prescribers (CPP) who run clinics in hospitals and polyclinics to issue MCs.
CPPs are highly qualified pharmacists and nurses who can review and prescribe medication independently within the scope of their Collaborative Practice Agreement.
The move will help reduce inefficiencies in Singapore's healthcare system amid an ageing population, Ms Quay said. "We need to focus on a team-based model of care where various healthcare professionals come together to provide cost-effective care outcomes," she added.
Furthermore, Ms Quay said, CPPs undergo rigorous training and audits to uphold high standards of care, and are equipped with necessary industry certifications.
"Currently, these practitioners can only provide excuse chits to patients. If patients require MCs, they have to be directed to medical doctors where they have to wait again for the doctors to furnish their MCs," Ms Quay added.
"It causes unnecessary delays to patients and can be disruptive to both the CPP and the doctor."
Member of Parliament for Ang Mo Kio GRC Intan Azura Mokhtar asked if the amendment could include recognising MCs from traditional Chinese medicine (TCM) practitioners who are registered with the Traditional Chinese Medicine Practitioners Board.
"There are increasingly more who prefer to get help from TCM practitioners for their ailments such as frozen shoulders, plantar fasciitis or even back pains, which can significantly affect work performance," Dr Intan said.
"These ailments may not have immediate cure from medications, but with consistent TCM treatments, much relief can be achieved."
In response, Mrs Teo said that a small number of doctors have dual registration under the Traditional Chinese Medicine Practitioners Act and Medical Registration Act (MRA).
"For the purposes of granting paid sick leave, employers are required to recognise the MCs issued by such practitioners in their capacity as doctors under the MRA," she added.
As for CPPs, Mrs Teo said that they are not registered under the MRA, and therefore the MOH has not allowed them to issue MCs.
"MOH will need time to assess them and other models of care," she added. "MOM will therefore continue to monitor and adjust the Employment Act if necessary."