Sickness absence as risk-taking behaviour: a study of organisational and cultural factors in the public sector

This article examines the organisational and cultural factors, both formal and informal, which lead to the inappropriate non-use of sick leave or 'pre senteeism'. A two-stage research process supplies the empirical data for th is paper. Preliminary quantitative research was gathered from 200 questionn aires sent to staff at two centres; however, the results from this stage we re inconclusive. The article therefore focuses on the findings from qualita tive data, gathered through the use of in-depth interviews and focus groups with 30 workers at a single site in the public sector. Taking further the study by McKevitt et al. (1997), we consider whether presenteeism results i n subsequently higher rates of sick leave. By understanding the fears assoc iated with taking sick leave, we suggest that sick leave can be understood as a 'risk-taking' activity rather than a health-promoting one. In addition , informal discussions with management suggest that managers do not appreci ate that policies designed to reduce sick leave may ultimately increase it. We suggest that a tendency to construct ideal models of the social and wor king environment may result in unintended and negative consequences for bot h employers and employees. Finally, we address briefly the social represent ation of sickness and the sick role. It is not usual for people to resist t he sick role, and we consider not only the factors which contribute to relu ctance to take sick leave, but also the attitudes of fellow workers to thos e who resist.