“I often have refusals of work stoppage that I offer, rather than abuses,” said Dr Patricia Lefébure, president of the Federation of Doctors of France

This text corresponds to the transcription of part of the interview above. Click on the video to watch the maintenance in full.

Work stoppages that cost 20 billion euros at a time when the government seeks to make 44 billion savings. Does it challenge?

Frédéric Bizard: Of course it challenges. In the 20 billion, there are 12 billion which are linked to sick leave and the rest, it is stops related to pregnancies and accidents at work. So, if we are interested in sick leave, we must see that the main determinant of the increase in value of these expenses, these are good causes. The first is that there is a sharp increase in wages from 2021 to 2023 to cover the inflationary peak: 16 % increase in the minimum wage. The second reason is that we created 1,600,000 additional jobs from 2021 to 2023. These two phenomena represent two thirds of the causes of the increase in expenses. And then there are bad reasons. A reason for public health. It is not the problem of aging that leads to health expenses, it is morbidity. So, if aging is healthy, which should be the case up to 70 years, as in the Nordic countries, there would be little impact of aging on assets. And then, the second reason is working conditions. You have three days of absenteeism rate in the bank and you have eleven in the hospital. The last point is that you have to put a little order in the functioning of these sick leave. How do we give sickness? Will we still continue with paper stops? I think it’s a concern. You have to scan all that so that we can have better control. And then, who should finance sick leave? It is the primary mission of health insurance. This is the concept of delayed salary, that is to say that you contribute so that when you are no longer able to work, you can have a substitution income. But should it be health insurance plus mutual? I think you have to clarify.

The government wishes to extend the deficiency period for work stoppages of 3 to 6 days. Dr Lefébure, you who are faced with reality, who receive patients: we suggest that employees would abuse. What is reality?

Patricia Lefébure: We hear that all the time, indeed. For our part, people do not abuse. We work on confidence, anyway. I often have refusals of work stoppage that I offer, rather than abuse. Afterwards, I can’t say that no one abuses. If the patient tells me that he has pain, I believe it. But the problem does not lie there. The problem lies in the cases developed by Frédéric Bizard, and also within the deadlines that we have to obtain opinions from occupational physicians. For example, before, you could have it within ten days. Now, it is sometimes necessary to wait two months to have an opinion for a reorientation in a position, to have additional examinations too, or to have a specialized opinion. I can’t put someone back on a site if I don’t know in what state is their knee, for example. So all that, these are things that, little by little, accumulate and that add to morbidity, that is to say the diseases of patients who are starting to become old, who find it difficult to work physically.

Do you feel that there is also a form of wear at work, a form of loss of sense of work?

Patricia Lefébure: In some situations, yes. There are people who are delighted to be at work. Obviously, we cannot hide either that there is a lot of suffering at work and that it is one of the longest work stoppages, because the most complex to put back. These are people who, with them, are fine. And as soon as they are put back in the atmosphere of work, of the position to which they are affected, again, make psychological, psychiatric decompensations. Even until you have suicidal ideas. It’s not just “I don’t feel good when I go to work”. No, it’s “I have weight loss, I don’t eat anymore, I stress, I don’t sleep at night”, etc. So these people, they can work, but not in the job they are. And that, the attending physician, that we accuse everything, he can do nothing. We need the help of the occupational doctor. Hence what I said at the start, and it’s always very long, indeed. Fortunately, there are lots of people who are delighted to go to work.

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