Ontario’s health workers call for improved sick leave policies

Ontario’s Ministry of Health and Long-Term Care advises people to stay home if they are sick, especially when it comes to infectious diseases like influenza. The Public Health Agency of Canada and the World Health Organization provide the same advice. Dr. Scott Wooder, former President of the Ontario Medical Association says: “…Going to work while sick is bad for you and potentially worse for your colleagues.” Even the Ontario Ministry of Labour Chief Physician, Dr. Leon Genesove, tells workers: “…Stay home if you are sick!”

Unfortunately, Ontario’s current employment laws do not protect workers when they fall ill. As a result, too many people have no other choice than to go to work sick, risking their and their co-workers’ health.

Unlike many jurisdictions around the world, Ontario does not have legislation requiring paid sick days. According to the Conference Board of Canada, less than half of older and younger workers in Canada have paid sick days. Workers in part-time, temporary or casual work and those earning low or minimum wages, are also much less likely to have paid sick days.

Without paid sick days, too many workers are forced to go to work sick to avoid losing pay. A CDC study of nearly 500 food service workers found that more than half (60%) had worked while ill. When asked why, most reported they did not want to lose income. Similarly, a study led by the Public Health Agency of Canada focusing on high-risk work settings (e.g. daycare workers, food handlers, and healthcare workers) found that a key reason why workers with gastrointestinal illness continued to work while ill was because “they could not afford to take time off.” Other studies indicate similar trends.

At the same time, evidence shows that providing paid sick days reduces the duration of illness as well as the risk of worsening minor conditions. Access to paid sick days is correlated with a higher return to work rate following heart attacks and an overall lower burden on health care resources. Conversely, the absence of paid sick days can reduce workplace productivity through increased transmission of influenza and increased “long-term sickness absenteeism.” People without paid sick leave are less likely to obtain preventive screening for breast, cervical, and colon cancer. Coming to work sick can cost up to three times as much as absenteeism if we account for depression and pain alone.

Beyond the financial penalty workers may face for taking a sick day, many workers risk losing their jobs altogether. In Ontario, the Employment Standards Act (ESA) exempts businesses with fewer than 50 employees from providing any job-protected, unpaid personal emergency leave.

Consequently, fully 1.6 million Ontarians cannot rely on the ESA for protection against losing their jobs for taking a sick day without pay.

Finally, in addition to all these barriers, workers can face even more hardship if they are required to provide medical notes as proof of illness – a practice all too common among employers.

To get a sick note, workers must either visit a clinic or hospital while sick (exposing themselves and others to infection) or make the visit at a later date and take additional time off work, likely incurring lost wages and transportation expenses in the process. If workers are charged a fee to obtain a medical note, their illness becomes even more expensive. Meanwhile, long waits for same day care can defeat the purpose of staying home to get well. When these visits are unnecessary, as in the case of minor viral illnesses, they contribute to unnecessary backlogs in patient care and cost the healthcare system as a whole.

For all these reasons, the Ontario Medical Association, Doctors of Nova Scotia and the Newfoundland and Labrador Medical Association have all called on employers to stop requiring medical notes.

As health workers, we know it is time to fix Ontario’s sick leave policies.

We call on our province to implement the following changes that would be good for health and wellbeing, for our healthcare system, and for workplaces:

Amend the Employment Standards Act so that all employees accrue a minimum of one (1) hour paid sick time for every 35 hours worked. For a full-time worker this would mean seven (7) paid sick days per year. Amend the Employment Standards Act to remove the exemption for businesses with fewer than 50 employees, so that all workers have access to unpaid, job-protected personal emergency leave. Amend the Employment Standards Act to prohibit employers from requiring evidence such as medical notes to entitle workers to personal emergency leave or paid sick days.