Airef, on linking absenteeism and sick leave: "I think it's dangerous"

MadridSick leave due to temporary incapacity (TI), that is, when a worker suffers an illness or accident that temporarily prevents them from performing their job, has skyrocketed since 2017. This has been confirmed by the Independent Authority for Fiscal Responsibility (AIReF) with the publication of a study on the evolution of social security coverage and its findings on this growth. Broadly speaking, from 2017 to 2024, sick leave due to temporary incapacity has increased by 60% in terms of incidence, while its duration has grown by an average of 15%, according to AIReF calculations. Specifically, the average duration of sick leave has increased from 40 days to 46, although in some conditions the increase has been even more pronounced: for mental health reasons, for example, it has risen from 67 days to 99. All of this has resulted in a tripling of spending: pensions. In 2024, these costs amounted to €16.5 billion for public coffers (between the 4th and 15th day of sick leave, the cost is shared with the company, and only from the 16th day onwards is it covered by Social Security), while in 2017 they amounted to €5.473 billion.

But before delving into the explanations that may help to understand what lies behind this scenario, it was noted during the presentation of the study that the document comes at a time when, in parallel with this increase in sick leave, the business community has been warning about absenteeism for some time, to the point that it has become one of the major concerns current issues. "I find this idea that people take sick leave for years on end just because dangerous... [...] We have to start from the premise that when someone doesn't go to work, it's because of [medical] leave. Whether there are cases of absenteeism or not, that's not where AIReF gets involved," the president of the press conference responded regarding the press conference on absenteeism and sick leave.

More control of Social Security

However, an initial explanation from AIReF (Independent Authority for Fiscal Responsibility) for this increase stems from a lack of coordination among the agencies involved in sick leave due to temporary incapacity (meaning public health services and the National Social Security Institute), which has led to a "structural deficiency" in management. The clinical decision to grant sick leave rests with primary care (doctors), which is under the jurisdiction of the autonomous communities, while the financial responsibility for the benefit lies with the central government. "The main weakness is the lack of robust and integrated mechanisms for information sharing, supervision, and monitoring between the regional health services [primary care] and Social Security," AIReF states, also pointing to the need for greater involvement from mutual insurance companies and employers. The solution is not easy due to the balance of responsibilities. In fact, the agency is avoiding any "change to the current rules of the game." In any case, it proposes that Social Security have a greater role in the control and supervision of sick leave, anticipating its intervention during the process—currently, it usually intervenes from the 365th day of sick leave onward, although it could do so earlier. Sources from the Ministry of Social Security maintain that they have "strengthened" the exchange of information with the healthcare system, as well as with mutual insurance companies and employers, and have called a meeting with unions and employers' associations on February 9th to discuss proposals for improvement. The department headed by Elma Saiz also points to the "saturation of the healthcare system" as a critical factor, as well as the overload of the Social Security Medical Inspection. Other causes

In fact, beyond this increased oversight, the Independent Authority for Fiscal Responsibility (AIReF) is also focusing on four other issues. Firstly, regulatory changes in labor matters, spearheaded by the latest major labor reform, have resulted in more protective regulations regarding sick leave, "reversing previous restrictions and expanding financial protection." Collective bargaining agreements have also improved in terms of worker protection. Secondly, there is an expanding economic cycle—more people in the labor market—and an increase in primary care consultations since the COVID-19 pandemic, which is straining the system, as well as an increase in waiting lists that directly impacts the duration of sick leave, AIReF notes. "There is a clear correlation between waiting lists and the duration of sick leave," the study concludes.