‘Treated like shirkers’: German unions cry foul over Merz’s sick-note crackdown

Original article by Deborah Cole in Berlin

A German proposal to end the right to get short-term sick leave from a doctor over the telephone as a means of cracking down on skiving has met with outcry from labour groups and the medical profession.

Germans enjoy some of the most generous employee illness policies in Europe, a fact the conservative chancellor, Friedrich Merz, says is undermining efforts to kickstart the EU’s biggest economy, whose growth has largely stalled since 2022.

At a regional campaign event last weekend, Merz said staff took an average 14.5 sick days per year – “too high”, he said.

“That’s nearly three weeks in which people in Germany don’t work due to illness,” he said. “Is that really correct? Is that really necessary?”

He later said that if the one or two days of recovery time not requiring a doctor’s note were taken into account the figure would be even larger.

Merz, who worked in the private sector for two decades before taking office last year, specifically blamed the phone option for patients, saying it made it far too easy to bunk off work.

He received support from the National Association of Statutory Health Insurance Physicians (KBV), whose chair, Andreas Gassen, said: “No one can reliably assess whether someone is truly unfit for work over the phone.”

Merz’s health minister, Nina Warken, said she would take the matter onboard with a critical review of the practice, most commonly used for minor illnesses not requiring medical treatment such as colds, flu and Covid-19.

“Compared with other countries, sick leave in Germany is high,” Warken told Berlin’s Tagesspiegel newspaper.

“The truth is that the low-threshold option of reporting sick by telephone can be abused,” she said. “That is exactly what we will tackle.”

However, the Social Democrats (SPD), junior partners in Merz’s government, argued that forcing such patients to see their doctor in person would amount to “harassment”.

Sicknotes by telephone were introduced during the Covid-19 pandemic to prevent the spread of infection and made permanent in 2023 under the then health minister Karl Lauterbach.

He said abolishing them now would be “counterproductive” because it would unnecessarily fill up waiting rooms at doctors’ surgeries.

Sharp criticism also came from the German Trade Union Confederation (DGB). Its leader, Yasmin Fahimi, called it “highly indecent to place employees who have called in sick under general suspicion, as if they were shirkers and slackers”.

Doctors’ groups also voiced opposition to changing the policy.

“All evaluations by health insurance companies to date confirm that sicknotes issued by telephone do not lead to greater abuse of sick leave,” Markus Beier, chair of the Association of General Practitioners, told the RND media group.

He stressed that doctors’ surgeries could only issue sick leave by telephone to patients already known to them and that it was capped at five days. Public health insurers say that sicknotes via telephone make up less than 1% of the total.

International comparisons can be difficult because of variations in how sick days are tallied. But a study conducted by the Iges Institute for the public health insurance company DAK showed Germany ranking in the upper midfield of European countries.

An evaluation of how much of weekly working time is lost because of illness put Germany at 6.8% – similar to Belgium (6.7), Sweden (6.6) and Iceland (6.1) in 2023. Norway was the frontrunner with 10.7%.

The Cologne-based economic institute IW said sick leave cost the economy €82bn in 2024, amounting to nearly €1,000 for each person a year and equalling military defence spending.

The BDA employers’ association noted that Germany was more generous to sick employees than nearly any other country in Europe, with full pay guaranteed by employers for 42 calendar days while off sick, after which health insurers step in to pay 70% of gross salaries.

Merz, who is historically unpopular, has repeatedly painted the national work ethic as a drag on the economy in swipes seen as targeting “lazy Germans”.

The chancellor, 70, said at a business conference last May: “We won’t be able to maintain the prosperity of this country with a four-day week and work-life balance.”

He has since said not “all Germans need to work more” but rather that the national average needed to be lifted.

A record 71% of Germans said in a representative poll this month they were unsatisfied with Merz’s government.