Spain’s mutuas could sign off sick leave: Feijóo’s plan

Feijóo proposes that mutuas sign workers off sick leave

Feijóo wants the mutuas (Spanish occupational mutual insurers) to be able to sign workers off sick leave. The PP leader’s proposal, with no legislative text and no known majority behind it, rests on a premise much of the business community takes for granted: fraud in sick leave is everyday and extremely costly. The flip side is less presentable. Those who end up paying for the control, workers themselves maintain, are the ones who really are injured.

The plan has landed in the middle of the debate over absenteeism and leaves an uncomfortable consensus. Almost no one defends it as it stands. Some because they believe handing the sign-off to the mutua is handing it to someone with an interest in not paying. Others because they see the PP shooting itself in the foot before it even governs.

The sick-leave fraud that fuels the proposal

There is an account that is repeated in detail. An employed worker describes cases of absenteeism “of immense shamelessness”, almost surreal, and says that in the public sector substitutes are chained: up to five people on sick leave for the same job. At his company, he adds, firms specialising in surveillance of workers on sick leave have already appeared, and he finds it reasonable: an SME ruined by a long absence has no one to give it its money back.

That account gives ammunition to the measure. The business thesis is simple: if faking it costs little and is detected late, fraud spreads. One visible case drags in colleagues and what began as an exception ends up as the norm. Absenteeism would not be individual bad faith, but a problem of badly set incentives.

Why are the mutuas not a neutral judge?

Because their legitimate interest is not to pay. That argument dominates the conversation: the mutua benefits from every sign-off it signs, so putting it in charge of deciding on the worker’s sick leave is seating the interested party at the judge’s table. If the doctor is also paid by targets, or has their contract renewed on those targets, the result becomes predictable.

The cases circulating are telling. A worker with a cruciate ligament tear, operated on and on sick leave for about three weeks, goes for a review and the mutua declares him fit. The problem: to reach the office you have to climb stairs and he still cannot. Another account is longer. An accident in a warehouse, tibia and fibula, four operations and nine months with no results; at fifteen months he moves to the mutua and at eighteen months the inspection signs him off with his foot barely able to bear weight because of a bone infection. The mutua, according to that testimony, was seeking permanent disability.

Who foots the bill: chronic patients and an ageing workforce

They pay, and for now without a discount. One phrase sums up the majority feeling: the innocent will end up paying for the guilty. No one claims doctors hand out sick notes like hotcakes; what is pointed to is a context that pushes up spending, with an ageing workforce in worse health than two decades ago. Mental health problems and drug use would be, according to some voices, the chapter almost no one wants to talk about.

The change in criteria for obtaining disability status is placed, in the most repeated version, between the end of Zapatero’s government and the start of Rajoy’s: requirements were toughened because spending had to be cut wherever possible. What was saved then is now being paid for in long sick leaves.

The political cost: subtracting votes before adding them

The political reading is that the PP is sabotaging itself. Touching sick pay for workers on leave does not win a vote and mobilises those who were already angry. Some say it bluntly: this one does not want to govern. He knows what is coming, with EU funds running out, inflation lingering and a recession in the air, and prefers opposition, where nothing has to be decided.

Even so, the measure has defenders in a hurry. Anyone who has seen a long sick leave take down a small company believes the current control does not work and that someone has to review it. The problem, even they admit, is who.

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With these ingredients, the reasonable prediction is not that the idea falls, but that it returns wrapped in safeguards. If the sign-off ends up depending on a doctor paid by the mutua, the number of sick leaves will fall. How much of that fall will be fraud caught and how much sick people pushed into work is a question without an answer and looking very likely to stay that way.