AMA hits out proposed changes to sick leave certification

The Australian Medical Association (AMA) president, Dr Mukesh Haikerwal, has hit out at plans by the Pharmacy Guild for pharmacists to take over the issuing of sick leave certificates for employees to have time off workm saying the plans confirm the AMA's warnings to the Federal Government of a major flaw in its Work Choices legislation.

Dr Haikerwal said the prospect of non-medical people "˜certifying' medical conditions and an individual's fitness for work is quite rightly a serious concern for employers and employees alike.

"On the one hand, the employers would have to accept certificates written by a whole range of health practitioners who are not doctors, and employees would be having their medical conditions and fitness for work assessed and certified by non-medical people," Dr Haikerwal said.

"This is potentially a huge problem that has a very simple solution "“ amend the legislation with the stroke of a pen.

"Medical certification is taken very seriously by doctors. A medical certificate is a legal document that, if breached, could affect a doctor's registration. Other groups are not subject to the same scrutiny or guidelines.

"A medical certificate is a contract that provides an honest and professional assessment of a person's health and whether that person is well enough to do their job at a certain time.

"Examination by a medical doctor ensures the patient's overall and longer term health is assessed and cared for in an holistic way.

"Handing medical certification over to non-medical people is devaluing the integrity of sick leave and fragmenting patient care.

"The health of workers and their fitness to be at work when ill should not be trivialised. It is time that common sense prevailed and this problem was fixed.

"Most employees will often return to work too sick to work, and should actually seek medical help if their illness is severe or persistent."

Dr Haikerwal said the Pharmacy Guild's comments are irresponsible and appear driven by their preoccupation with pharmacists taking over the work of doctors.

"While diagnosing, dispensing and issuing sick leave certificates may be attractive to the Pharmacy Guild as a business plan for pharmacists, it would not be beneficial to patients.

"The Guild's response is evidence that many groups will jump in to write certificates that confirm ill-health, but on what professional basis and on what medical criteria?

"Doctors are best placed to manage patient care, including certifying sick leave when needed."

Dr Haikerwal said that the Government has claimed that the late changes to Work Choices were meant to relieve the burden on doctors, but there would only have been a burden if the Government had insisted that workers would need a new medical certificate for every occasion they were off work on sick leave.

"In making the changes "“ essentially changing the term "˜medical practitioner' to "˜registered health practitioner' for the issuing of certificates "“ the Government has opened up a hole in the side of the legislation and ensured confusion and uncertainty for employers," Dr Haikerwal said.

"The changes will allow "˜registered health practitioners' to issue certificates to workers for extended absences from work up to their full allowance, which could be ten days a year or more.

"Employers will now be presented with sick leave certificates from everyone from osteopaths and Traditional Chinese Medicine practitioners to pharmacists, chiropractors and acupuncturists, depending on who is classified as a "˜registered health practitioner' under State and Territory legislation.

"For example, the AMA has obtained a medical certificate signed by a Traditional Chinese Medicine practitioner in Victoria covering two days sick leave.

"The certificate simply stated that the patient was receiving medical treatment and was unfit for work.

"The certificate identifies the practitioner as a doctor - even though he is not a medical practitioner.

"Under Chinese Medical Registration Board guidelines in Victoria, he can call himself a doctor. Employers would be horrified to know that this is what Work Choices allows.

"Industrial Awards, agreements and the courts have all generally recognised that medical practitioners should sign medical certificates for good reason.

"The AMA believes that the Government should have followed well-known and established industrial practice with Work Choices, whereby employees are normally allowed two single day absences each year without having to produce a medical certificate.

"That system is fair on employees, fair on employers and ensures that doctors are not dealing with minor complaints."