This is a measure that has resurfaced in recent years. In a report criticism of the policy to combat medical desertions, published Monday May 13, the Court of Auditors suggests that political leaders “explore” the idea of removing medical certificates for work stoppages of “very short duration”.
In practice, this means that patients could declare their sick leave themselves. According to the report, the procedure would allow doctors to waste less time, focusing on patients who need care the most.
Questioned Tuesday morning on TF1, the Minister for Health Frédéric Valletoux said he wanted to “open [ce sujet] with employers.” “We must, with the employer networks, discuss the feasibility of this measure, which would free up medical time,” he declared. “The question is indeed to see its supervision and ensure that this is not a new channel of abuse, it is a balance to find, but in any case the measure deserves to be discussed” and “we will look at it closely”, he insisted.
Not a new idea
Is this a paradigm shift? Last year, in June 2023, as part of the examination of the bill aimed at improving access to care through the territorial commitment of health professionals by the Social Affairs Committee, Frédéric Valletoux spoke clearly opposed to a proposal giving patients the possibility of self-declaring for stops of less than three days. The amendment, which aimed to “free up medical time”, was therefore not retained by the deputies.
“We might think that freeing up medical time for this type of work stoppage is something positive and that it has no consequences. But we must take into account that removing the need for a medical certificate for “self-declared work stoppages call into question a certain balance found between employees, Social Security and employers”, he considered.
Self-declared work stoppages are not a new development and have even been used before. During the Covid-19 epidemic, the measure was briefly put in place so that symptomatic or contact people isolate themselves as quickly as possible, to avoid contamination at work. A list of illnesses giving the right to self-declare sick leave had even been specified by Health Insurance on the basis of recommendations first established by the High Council for Public Health.
The example of the United Kingdom, Quebec and Portugal
“It exists elsewhere and it works,” underlined Monday the first president of the Court of Auditors, Pierre Moscovici. “In the French landscape this seems surprising, but this principle of self-declaration of short-term stops has been in force for many years in several neighboring countries,” he added. “It goes without saying that such a system cannot be put in place without a regulatory system”, however, hastened to clarify the first President of the Court.
Indeed, in the United Kingdom for example, the self-certification procedure for stops of less than seven days, generalized in 1985, is today “used routinely” via a simple form to fill out. The employee “can be paid for his days of absence beyond three days”, observes the Court in its report.
Since April 2023, Portugal has also adopted the measure. The Portuguese can thus declare a work stoppage for up to three days, simply by “self-declaring” illness via the Internet or telephone. The measure would not involve any cost for the State or the employer, since the maximum duration of the stoppage corresponds to the waiting period during which the employee is not paid by Social Security, according to the Portuguese Ministry of Health .
In France, the subject nevertheless remains subject to numerous debates, more or less heated. “We are killing our dog by saying that it has rabies, by demolishing general medicine and the real role of primary care medicine,” reacted to Franceinfo Didier Simon, general delegate of the union of General Practitioners of France.