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       Hazards, number 154, 2021
SICKENING | We are at risk as long as going sick equals going without
It’s a simple choice – your money or your life. In a perverse twist, millions of the workers at highest risk of Covid-19 because of their jobs have been left with access to little and sometimes no sick pay.


Boris Johnson and his changing line up want us to think it’s all over. Ministers, buoyed by the vaccination programme, are saying goodbye to masks and of a new “freedom” from restrictions.

The vaccine has had a remarkable impact. Hospitals can cope, and while people are still dying from Covid-19, as far as the government is concerned the death rate is acceptably low. But vaccines aren’t bullet proof, and a nation of unvaccinated and often asymptomatic children has left the virus simmering in schools.

The downward trend in workplace ‘incidents’ and ‘clusters’ since the peak of the second wave in mid-January reversed in June and has been creeping upwards. By the start of July, rates were back at levels last seen in March [See: All over?].

Workplace health specialists had seen it coming. In late April 2021, the British Occupational Hygiene Society, a scientific charity and the chartered society for industrial hygiene specialists,  said while vaccination is likely to have a significant impact on workplace transmission “simply relying on vaccination, at least in coming months, would be a risky strategy for employers and may contribute to outbreaks, undermine the public health benefits of the vaccine programme, or even land the employer in hot water legally.”

BOHS CEO, Professor Kevin Bampton, warned: “Suppressing the risk of asymptomatic infection is not only important to protect workers themselves, but also to reduce the amount of virus in circulation and the potential breeding grounds for new variants. The vaccine promises light at the end of the tunnel, but we are not out of it yet.”

Making a living

The prime minister has conceded his plan is no longer to ‘defeat’ the virus. Instead people will have to “learn to live with Covid”, with UK government policy switching from enforcing rules to encouraging personal responsibility.

Key to this is staying off work when symptomatic or if required to self-isolate. But critics say that is only an option for those that can afford it. A TUC analysis published on 24 June 2021 revealed that one in 12 key workers - 788,000 people - do not qualify for statutory sick pay (SSP), despite many of them being at greater risk from Covid-19 due to the frontline nature of their job.

POOR POORLY Over a quarter of cleaners and retail staff earn too little to qualify for statutory sick pay, so may not be able to afford to go sick or self-isolate, the TUC found.

The TUC research found those excluded from SSP include more than a quarter of cleaners (27 per cent) and retail workers (26 per cent), nearly one in 10 teaching assistants (9 per cent), and over one in 20 care workers (6 per cent).

Additional figures from polling for the TUC by BritainThinks show that a third (33 per cent) of key workers report getting less than full sick pay (below their usual rate of pay); and a quarter (24 per cent) report getting only SSP.

The UK currently has one of the lowest rates of statutory sick pay in Europe and nearly two million workers do not earn enough to qualify for it – most of them women.  Workers receiving statutory maternity, paternity, adoption or additional paternity pay are not eligible for SSP. The self-employed are also excluded.

Poverty doesn’t work

The TUC described as ‘miserly’ the UK government’s 50p rise in SSP from £95.85 to £96.35 a week on 6 April 2021, with TUC general secretary Frances O’Grady adding ministers “need to raise statutory sick pay to the level of the real Living Wage, and make sure everyone can get it.” The TUC leader warned “the government’s failure to act is undermining our public health effort.”

SELF-DEFEATING The majority of applications to the UK government’s self-isolation payments scheme are still being turned down, despite increased government funding for the scheme, new research for the TUC has found.
[See: TUC slams ‘failing’ self-isolation scheme].

TUC polling published in January 2021 revealed that two-fifths (40 per cent) of workers say they would have to go into debt, or go into arrears on their bills, if their income dropped to £96 a week.

It is hurting those workers we rely upon most. The findings of a UNISON survey of over 4,000 care staff published in June 2021 revealed half (51 per cent) of those surveyed have had to self-isolate during the pandemic, and only half of those received full pay. Over 1-in-10 (11 per cent) received nothing and a third received statutory sick pay of just £96.35 a week.

SICK LEADERSHIP  The TUC has accused the UK government of abandoning low-paid workers after it reneged in a 20 July 2021 consultation response on plans to reform statutory sick pay – including removing the ‘lower earnings limit’ to ensure all workers can access sick pay.
[See: UK government reneges on sick pay reforms]

UNISON general secretary Christina McAnea said: “It’s over a year into the pandemic and staff still face severe financial hardship for self-isolating. Care workers who follow official health guidance mustn’t be penalised with huge cuts in wages. Not paying those affected by Covid puts the vulnerable at risk by driving up infections.” She added: “The government should ensure all care employers guarantee staff full income. The care sector also needs to be reformed urgently and that includes decent wages for workers.”

Workers who know a positive test and self-isolating face might mean losing their home or not being able to feed the kids are left with an impossible choice. Many will feel it is no choice at all, creating a public health conflict only the virus can win.

Making it better

Union concerns about the damaging public health implications of low or absent sick pay have been borne out by research – including some from the UK government’s own public health agency.

A 31 March 2021 paper in the British Medical Journal (BMJ) suggested just 18 per cent of those with symptoms said they had requested a test, while only 43 per cent with symptoms in the previous seven days adhered to full self-isolation. The authors, from King’s College London, UCL and Public Health England, concluded: “Policies that support people financially and practically, and improving communication about the testing system, will be key to increasing uptake both in the UK and internationally.”


The TUC is calling for sick pay to be reformed. It says the UK government should:

Scrap the minimum earnings threshold for statutory sick pay
Increase the level of sick pay to at least £330 per week
Give employers the resources to afford sick pay for their workers.

Sign the TUC petition demanding #SickPayForAll.

A British Medical Journal commentary published on 5 April 2021 and authored by Stephen Reicher, John Drury and Susan Michie, all of whom serve on the UK government’s Sage group or its subgroups as well as Independent SAGE, noted that for many months, there has been concern at the low levels of adherence among those asked to self-isolate because they have symptoms or a positive test for the coronavirus, or are contacts of a positive case.

The commentary notes: “If the importance of self-isolation is actually greater than we thought before, it is equally true that the need to improve support for self-isolation is more urgent as a policy priority.”

The authors add: “We need to get to a point where we are able to deal with infection outbreaks through a targeted policy of rapid testing, forwards and backwards testing, and of taking infected people out of community circulation. We cannot do that without better support for isolation. So, without support for isolation, talk of a ‘road map’ that is irreversible and of never returning to lockdown is precisely that. Just talk.”

A May 2021 report from the Nuffield Trust and the Resolution Foundation called on the UK government to increase self-isolation support to ensure the success of the vaccine rollout. The thinktanks warned that boosting compliance with self-isolation rules is critical to resisting the threats posed by new variants of coronavirus and rising cases as restrictions continue to ease.

The report stated that asking people with Covid-19 to self-isolate is vital to keep the pandemic under control as lockdown measures ease, yet only 52 per cent of people who have symptoms isolate. Resolution Foundation chief economist Mike Brewer said: “The UK’s failure to financially support workers who need to self-isolate has severely hampered efforts to curb the spread of the virus.”

A living wage

Providing this support is easily affordable. Research commissioned by the TUC from the Fabian Society and published in Statutory Sick Pay: Options for reform on 24 June 2021 calculated the cost of raising SSP to the equivalent of the real Living Wage for employers without an occupational sick pay scheme would be around £110 per employee per year – or just over £2 a week.

“Nobody should have to choose between going into work if they’re sick or should be self-isolating, or doing the right thing by staying home, but facing hardship as a result,” TUC leader Frances O’Grady said.

“The cost of fixing the UK’s broken sick pay system is small compared to other public health measures like test and trace. Ministers must urgently make every worker eligible for statutory sick pay. And it should be worth at least as much as the real Living Wage.”

Selected sources

Louise E Smith and others. Adherence to the test, trace, and isolate system in the UK: results from 37 nationally representative surveys. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n608. Published 31 March 2021.
Hao-Yuan Cheng, Ted Cohen and Hsien-Ho Lin. Test, trace, and isolate in the UK, BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n822. Published 31 March 2021.
Stephen Reicher, John Drury and Susan Michie. Contrasting figures on adherence to self-isolation show that support is even more important than ever, BMJ commentary, 5 April 2021.
Tackling Covid-19: A case for better financial support to self-isolate, Sarah Reed, William Palmer, Mike Brewer and Maja Gustafsson, Nuffield Trust/Resolution Foundation, May 2021.
Statutory Sick Pay: Options for reform, Fabian Society, 2021.

TUC slams ‘failing’ self-isolation scheme

The majority of applications to the UK government’s self-isolation payments scheme are still being turned down, despite increased government funding for the scheme, research for the TUC has found.

This June 2021 analysis is based on freedom of information (FOI) data collected by the TUC from 94 councils across England. The FOIs shows that since the government announced additional funding for the scheme at the end of February, 64 per cent of applications have been rejected, while just 36 per cent of applicants received the one-off £500 grant to help them self-isolate.

TUC polling, conducted by BritainThinks, revealed that just 1 in 5 (21 per cent) working people are aware of the self-isolation payment scheme. The TUC branded it a “failing scheme that few people have heard of”. 

It points out the scheme is even less known among those who would need it:

For those who work outside the home, just 19 per cent are aware of the scheme;
Just 16 per cent of those who say they do not receive SSP are aware of the scheme; and
Only 16 per cent of those earning £15,000 a year or less are aware of the scheme.

TUC general secretary Frances O’Grady said: “The self-isolation payment scheme is failing. And it has been crystal clear since the start of the pandemic that the UK’s measly statutory sick pay isn't enough to live on.”

The TUC said these findings demonstrate the urgent need to raise statutory sick pay to the level of the real Living Wage of £330 a week and extend it to all workers. This will stop workers suffering hardship when required to self-isolate.

O’Grady said: “The combination of new variants, reopened indoor hospitality and increasing numbers returning to their workplace could once again brutally expose the lack of financial support available for those needing to self-isolate. Enough is enough. Ministers must urgently raise statutory sick pay to at least the real Living Wage. And they must ensure that everyone has access to it.”

The UK currently has one of the lowest rates of sick pay in Europe and nearly two million workers do not earn enough to qualify for it – most of them women.

Unite said evidence the UK government deliberately suppressed information on how workers could be temporarily furloughed on 80 per cent of their wages when forced to self-isolate due to Covid-19 has exposed a “reckless” approach that has “cost lives”.

Leaked emails revealed that in January and February 2021 — when the second wave was surging — the Treasury instructed senior government officials to conceal from the public how a little-known part of the furlough scheme could be used to access isolation sick pay, as the cost of the Coronavirus Job Retention Scheme soared.

On 6 July 2021, health secretary Sajid Javid announced self-isolation rules in England would change. He said from 16 August 2021 double jabbed close contacts of people who have tested positive would not longer need to self-isolate. He added that under-18s would also be exempted from the self-isolation rules.


UK government reneges on sick pay reforms

The TUC has accused the UK government of abandoning low-paid workers after it reneged on plans to reform statutory sick pay – including removing the ‘lower earnings limit’ to ensure all workers can access sick pay. According to a TUC analysis, two million workers in the UK do not earn enough to qualify for statutory sick pay. The union body said the government’s failure to include sick pay reform in its 20 July response to the 'Health is everyone's business' consultation is “yet another example of penny pinching and grossly irresponsible.”

TUC general secretary Frances O’Grady said: “The government has abandoned millions of low-paid workers at the worst possible time. With Covid cases going through the roof, its refusal to make sick pay available for all is grossly irresponsible and will help drive infections still higher. This is yet another example of short-sighted penny pinching from the Treasury, which is undermining Britain's public health effort.”

The TUC leader added: “Rather than supporting people to self-isolate, ministers are making it financially impossible. This boils down to political choices. Giving everyone access to statutory sick pay would cost less than one per cent of the failed test and trace scheme. Over a year and a half into the pandemic, it's high time the government did the right thing by making sick pay available to all and raising it to a real Living Wage.” As recently as January, ministers had promised reforms that would address the level of sick pay and the lower earnings limit, but have since been blocked by the chancellor.

STUC general secretary Roz Foyer commented: “It is an absolute scandal that a global pandemic, where thousands of people need to isolate to keep us all safe, has not yet pushed the UK government to increase our paltry sick pay levels.”  She added: “Sick pay is a public health issue. It will often determine whether a worker can self-isolate or not, and that should worry us all. For workers to properly follow the current guidance, support must be there for them to do so without falling into debt, missing rent payments or being unable to provide for themselves and their dependants. For many part-time and insecure workers, sick pay isn’t even available to them.

“The UK government is putting us all at risk by not tackling this glaring issue. This makes it all the more important that employers in Scotland provide fair work that delivers adequate levels of sick pay to all workers.”

• Health is everyone’s business: proposals to reduce ill health-related job loss, UK government consultation response, 20 July 2021.


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It’s a simple choice – your money or your life. In a perverse twist, millions of the workers at highest risk of Covid-19 because of their jobs have been left with access to little and sometimes no sick pay. 

Making a living
Poverty doesn’t work
Making it better
A living wage
Selected sources

Other stories
TUC slams ‘failing’ self-isolation scheme
UK government reneges on sick pay reforms

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