The activation logic in national sickness absence policies: Comparing the Netherlands, Denmark and Ireland

Abstract

We compare sickness absence policies in the Netherlands, Denmark and Ireland, examining whether and how the institutional logic of 'activation' that is paramount in Europe is understood and given shape in each country. They differ in their support for the underlying ideas of 'activation', and especially vary in the design of their governance systems, as can be seen in the allocation of responsibilities, the description of return-to-work routines and the use of regulative instruments. We contribute to institutional theory by demonstrating the important but often neglected role of national governance systems in the macro-micro linkage between institutional logics and organizational and individual behaviour. Since sickness absence is a major cause of workforce inactivity, the practical relevance of this study is the comparative reflection on recent policy developments to improve sickness absence management.

Reasons for Sickness Absence: A Review of Medical Certification Data in the Republic of Ireland between 2008 and 2014

“…Although there appears to be a decreasing trend in overall individual claimants over the period, this is most likely as a result of changes in the recent waiting period of 3 to 6 days for claiming illness benefit and the current economic conditions [13,24]. At present, there appears to be no clear role within the Department of Health in the ROI in use of sickness certification data in determining healthcare utilisation resourcing and planning.…”

“Dis-able bodied” or “dis-able minded”: stakeholders’ return-to-work experiences compared between physical and mental health conditions

“…27] and included two countries with varying RTW legislation for workplaces, ranging from strong "must rules" in the Netherlands [27] to weak "may rules" in Denmark. [31] While similar perceptions of the differences between (the RTW process for) physical and mental cases were observed, workplace actors' behavior differed between the two countries, with varying consequences for the RTW process. In our Dutch cases, and according to the legislation, RTW plans were made (where possible), but the obligatory problem analysis has led to the imposition of an activation approach on (mentally) sick-listed employees -albeit with a counterproductive effect.…”

“…Workplace actors in both countries have obtained a statutory role in activating sicklisted employees to RTW early, albeit to a different extent. Legislation in the Netherlands stipulates that the RTW process is the shared responsibility of employers and employees; by contrast, since legislation in Denmark places the responsibility to initiate the RTW process with municipalities, less policy initiatives are focused on workplace actors, [15,31] who are the focus of this study. As shown in Table 1, the Dutch RTW legislation for workplaces is characterized by extensive, obligatory "must rules" coupled with sanctions, [27] whereas noncompulsory "may rules" (without sanctions) are characteristic of the Danish legislation.…”

“…As shown in Table 1, the Dutch RTW legislation for workplaces is characterized by extensive, obligatory "must rules" coupled with sanctions, [27] whereas noncompulsory "may rules" (without sanctions) are characteristic of the Danish legislation. [31] However, despite this difference, the RTW legislation contains similar "activation" components in both countries, such as an analysis of the remaining work ability of sick-listed employees (i.e. the problem analysis in the Netherlands and the possibility attest in Denmark), a RTW plan, and meetings between sick-listed employees and their employers.…”

“…These countries are viewed as frontrunners in the "activation" of sick-listed employees to RTW early, [29,30] yet differ regarding the degree to which workplaces are given a statutory role in this process. [31] The RTW legislation of the two countries is further explained and compared below.…”