The ‘fit note’: human rights breach or innovation?

by Chloe Taylor21 Sep 2015
The days of employees obtaining a sick note to validate time off could soon be a thing of the past.

Hundreds of GPs around Canberra will soon be using a new approach to approving sick leave by providing “fit notes” instead of sick notes.

According to reports, a number of the capital’s medical practices have been using the new method in recent months. The new practice sees doctors presenting patients with notes that inform their bosses of what they are able to do, as opposed to a list of what they cannot.

In May, Fairfax Media reported that workplace insurer Comcare was vying for Australia to adopt the system – which is used in the United Kingdom – as a part of its Health Benefits of Work program.

According to Comcare’s research, the traditional approach of sending sick employees home and awaiting their recovery does more harm than good.

The new approach has been experimented with, and is reportedly ready to be rolled out across 400 GP practices around Canberra.

Employment Minister Eric Abetz suggested on Wednesday that he would like to see the fit note being used around Australia if its trial in Canberra is successful.

According to Fairfax, the certificates allow GPs to nominate patients for phased returns to work, alternative hours, a “get-well program”, or changes to the workplace environment. Under the current system, none of these options are available to Australian doctors.

“It does actually make you think about the patient in difference ways and I think it's very helpful to get patients thinking about what they can do rather than what they can't do,” Rashmi Sharma, a GP and former chairwoman of the ACT's Medicare local network, told The Canberra Times.

“The way the form's wording has been designed, it enables you to have that conversation with the patient. You fill this form out with the person in the room helping you fill it out and I think in the past we didn't always have those conversations.”

She added that the fit note system gave insurers, employers and patients a say in the management of injuries, illnesses and other causes of workplace absences.

However, the ACT government has discredited the new system as an “abuse of human rights”, throwing the fit note’s future into uncertainty.

The fit note has reportedly been referred to the ACT’s Human Rights Commission, where it will be investigated over allegations that the system breaches privacy, human rights or medical records legislation.

Comcare has since argued that the notes are not a human rights breach, but the insurer said that it welcomed the examination.

The ACT and ACTU claimed that as it stands, the fit note could encourage the inappropriate sharing of personal medical information to an insurer or employer.

Fairfax also reported that the ACT government is currently neither mandating nor promoting the fit note, although it has no control over Canberra’s GPs.

A spokesman for Comcare said in a statement that the insurer believed the Human Rights Commission would approve the fit note’s use.

“Comcare does not believe the certificate encourages the inappropriate disclosure of private medical information, and we welcome the ACT Government testing this with the ACT Human Rights Commissioner,” he told Fairfax.

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  • by HR Dude 21/09/2015 10:33:21 AM

    Human rights breach...?

    Medical records can be released with consent, I don't see how this could be a break of any rights. The other side of course is that if you present to a doctor and are given a blanket 'unable to attend work' then you re ignoring the reality of different workplaces.

    Already in the areas of workcover and OHS we have reasonable adjustments that take place to allow workers to come back to work. This includes formal and informal processes. It's odd, to say the least, that we would want people to stay at home and sit around because they have sprained a wrist.

  • by Concerned 21/09/2015 10:48:04 AM

    What about people who are trying to take time off for their mental health?
    I can't imagine being vetted to see what tasks they're fit to do would be very pleasant.
    This smacks a little of placing productivity and profitability over employee health concerns.

  • by Another HR Dude 21/09/2015 2:04:31 PM

    @Concerned. If someone has a mental health issue and the Doctor assesses that they cannot do any work, then they'll get a note to say they aren't fit for any work. If they are capable of doing something (and this may be helpful to them), they'll get a note stating what they can do. The current system is floored in that it only gives the Doctor one choice. The new system improves on this by giving them the flexibility to say when people are capable of doing some work.

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