The strong and growing increase in medical leave processes among workers is a cause for concern for employers, unions and the Government itself. The question now is how to tackle the problem, and the solutions provided by both parties are very different from each other. The employers’ association of Catalan SMEs, Pimec, which has a lot of weight in Parliament through its good relationship with Junts, presented this Wednesday in Madrid that they defend the employers’ interests and among which one stands out: that the doctors of the mutual societies that collaborate with Social Security can give all the registrations and cancellations to the workers.
Currently, because they are business associations, but not for profit, that are authorized and controlled by the Ministry of Social Security. They manage public money (social contributions) and also help manage temporary disability benefits for workers who are on sick leave. The law only allows doctors from these entities to give discharges in cases in which the discharge has occurred due to a work accident. However, sick leave, regardless of the origin of the pathology (due to an accident or common illness), can only be given by doctors in the public primary care system.
Historically, employers have demanded that mutual insurance doctors be able to give sick leave due to common illnesses, but this proposal has never come to fruition. Now Pimec goes one step further and also requests that these doctors, whose employer is a mutual insurance company, can also determine workers’ sick leave. “It is incoherent that mutual insurance companies can discharge sick leave due to accident and sick leave and not the rest of the high time. A doctor is just as ethical and a good person if he leaves his home to work at a mutual insurance company or at a health center,” defended the general secretary of Pimec, Josep Ginesta.
Airef itself, dedicated to auditing public policies, has just denounced structural deficiencies in the sick leave management system. One of these deficiencies is, according to Pimec, that “the one who recognizes the sick leave and gives the new sick leave (primary care doctors dependent on the autonomous communities) are not the ones who pay them (Social Security dependent on the State) and the companies (which pay between the 4th and 16th day of the sick leave). “This would be solved by giving this power to the mutual insurance companies,” these employer leaders emphasize.
What’s more, the employers’ association of Catalan SMEs has indicated that, in their opinion “incorrectly”, the management of mutual societies had in recent years drifted towards public management to a greater extent than private management, which is why this organization also demands that this situation be reversed. To this end, they propose that the obligation to allocate mutual benefits to a reserve fund disappear, something that has always been rejected by successive governments and by unions.
The president of Pimec, Antoni Cañete, has made a second proposal to solve the increase in sick leave, which has to do with the design of the current salary supplements, which are included in many collective agreements, to compensate for temporary disability benefits, the amount of which is lower than the salary. According to him, these supplements act as a “call effect” so that workers are more likely to go to the doctor to ask for sick leave, because they prevent them from losing money. For this reason, these business leaders have explained that their representatives in the agreement negotiations have already begun to demand a reformulation of these supplements so that they are paid in the first sick leave, but decrease if these sickness absence processes are repeated in the same year, for example.
Now, Pimec will make a “round with all the parliamentary groups” to try to get them to endorse the employers’ demands, through legislative proposals, especially with amendments to the possible legal texts that reach Parliament as a result of the current negotiation in the social dialogue to modify the management of sick leave. In addition, the employers’ association will meet this Thursday with the Minister of Social Security, Elma Saiz, to whom they will convey their proposals.
The figures
The figures from the exhaustive report prepared by the Observatori de la pime de Catalunya for Pimec, with official data from the INE, Social Security and the mutual employers’ association (AMAT), During the period analyzed (2013-2025) the average hours lost by each worker per month have gone from 3.7 hours to 8.2 hours. Which means an average of one hour lost per month for each employee.
This study, in any case, shows that this is an average because some workers are never on sick leave and others have many sick days. Thus, more than 50% of workers have had two or more sick leave processes in their working life, while half of workers also account for more than 75% of all episodes of temporary disability.
According to the calculations of this work, the average annual cost of these sick leave for the company per hired worker is 2,459 euros per year. In aggregate terms, the costs of sick leave to the State and companies could rise until 2024. This figure is broken down as follows: 15,014 million in temporary disability benefits paid by Social Security; another 14.1 billion paid by the companies corresponding to the salary from the fourth day of absence until the 16th (from then on it is assumed by Social Security); and 133,448 million more for the opportunity cost (what the sick worker stops producing).
The study also highlights that the greatest number of absences occur in large industrial companies, “although the magnitude of the impact of absences for this reason is much greater in SMEs,” said Ginesta. Likewise, it has drawn attention to the sharp increase in discharges due to mental illness, which have grown by 112% between 2017 and 2024, compared to an increase of 47% in total processes in that period.
