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Doctors under fire over number of sick days they grant French workers

GPs that hand out too many illness days could face a fine of up €9,000

Around 1,000 doctors in France are ‘heavy prescribers’ of sick leave, according to Assurance Maladie Pic: ZhakYaroslav / Shutterstock

France’s main GP union has criticised the country’s public health insurance body for its plans to crack down on the number of sick days doctors grant their patients.

A new campaign by Assurance Maladie is looking to limit how many sick days doctors give workers in France after a study revealed almost half of workers had more than three consecutive days of absence in 2022. 

Doctors who are seen as giving too many sick days will have to justify their choices, and if Assurance Maladie deems it unreasonable, GPs could face fines of up to €9,000. 

Up to 15,000 doctors will be visited as part of the checks, with around one thousand already singled out as ‘high prescribers’ of sick leave.

The Fédération française des médecins généralistes union for GPs says the campaign is making a “scapegoat” out of doctors, and they “severely condemn” the government’s plans. 

For its part, Assurance Maladie states the campaign is a return to normal controls that were paused during Covid, and that it was legitimate to assess doctors who “prescribe five to ten times more [sick days] than the national average.” 

‘A campaign of intimidation’

The campaign has been met with anger by GPs, who see it simply as another attack on their profession.

“There are abuses of daily allowances, but very few among GPs… [mostly] on teleconsultation platforms,” said union president Agnès Giannotti in response to the announcement. 

“Who deregulated [GP services]? It was the government. Who gave the platforms direct access to Mon Espace Sante (editor’s note: the online health space which shows a patient’s health history)? The government. Pointing the finger at GPs is absolutely scandalous,” she added.

For her, the root cause of the problem is sociological issues, not being adequately addressed. 

“The need for care is increasing, the population is ageing, the retirement age is being pushed back… [we need] a responsible policy that anticipates these rising costs,” she said. 

Instead, she feels the government is looking to limit current expenditure, with a lack of long-term vision. 

France’s finance minister Bruno Le Maire announced on Monday (June 19) that at least €10 billion worth of savings need to be made by the French state before 2027, mostly coming from the health and labour ministers. 

Read more: Are you benefiting from the free cancer screening available in France?

More workers taking sick days – but for shorter stretches

Assurance Maladie says the state’s expenditure for sick leave absences increased by 7.4% in 2022 and has risen by an average of 6.6.% per year since Covid. 

“Growth in salaries and employment alone does not explain this rise in expenditure,” it said. 

The number of people taking three consecutive days of leave at least once in a year – 48% of the working population in 2022 – was considerably higher than the 36% in 2021, or 39% in 2020. 

This metric is focused on in particular because three consecutive sick days is the minimum amount required to qualify for sick leave payments in France. 

This three-day rule was temporarily reduced during the Covid-19 pandemic, but the original rules were recently re-established, which may go towards explaining why Assurance Maladie’s crackdown has swung into gear. 

Despite the increase in people taking consecutive sick days, the average leave of absence when on sick leave fell considerably – 32 days per year in 2020 compared to only 26 in 2022. 

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