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

GPs in Canberra have begun to use the proposed replacement for traditional sick notes – but it is already facing an investigation by the Human Rights Commission.

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