That sick leave could land you in jail

In TT a doctor can only 'recommend' a sick leave certificate; the employer must authorise it. Photo taken from theguardian.com -
In TT a doctor can only 'recommend' a sick leave certificate; the employer must authorise it. Photo taken from theguardian.com -

There is a section of the Industrial Relations Act that is seldom mentioned. It has even more seldom ever been used. It is Section 77, for those of you who have to deal with absenteeism due to illness and may want to look it up.

It applies to doctors, or “medical practitioners.” Defined in the act as: "a person registered under the Medical Board Act” (the board was established in 1887) and it makes it an offence under law for one thus registered by “deception,” defined as: “the fraudulent or deceitful use of a medical certificate,” to issue you one. You know, like when you need to get a licence for something that requires a medical certificate, and you are underage but look older in your father’s suit? If you can get the certificate with a blue note, and not so much as a glance at your birth certificate, no questions asked, it is quite possible there is a “deceitful use” contemplated.

Then the act goes on to actually define what is meant by “a medical certificate.” It means “a document of a medical practitioner certifying that a person is suffering from physical, mental, nervous or other illness, and recommending, or purporting to recommend, that some period of time should be spent away from work on account of the illness.”

Please note that in TT a doctor does not have the legal authority to enforce a sick-leave certificate. A doctor can only “recommend.” The employer must authorise it.

I thought about this last week reading about the crackdown in Italy way back when public servants who were guilty of fraud, in that they were collecting salaries and wages from the government but not showing up for work, and were therefore convicted of fraud against the State and actually jailed. Some, even worse, would show up, sign in and within the next hour or two, leave and go about their (personal) business. Senior nurses (
matronas) who signed in and were paid to supervise work in the blood bank, for example, but left work to juniors, ended up out of a job and in prison.

But what about doctors? I didn’t believe those elevated beings who had sworn the Hippocratic Oath would do things like that. I knew, from the time I was 11, that doctors were honest and morally upright.

My father was a doctor in a remote country location. At least half of his patients paid him in ground provisions and, if we were lucky, a chicken to eat on Sundays. Only a few of the others ever got around to paying at all. Hence the chickens.

He was so honest he would never even cheat on his income tax. I knew about that because my mother was the accountant who had to fill in the forms, grumbling under her breath as she did so. How do you calculate the value of ground provisions brought in by a weary farmer whose daughter had not died after all due to my father’s unfailing midnight care?

So when I read about an Italian DPP named Luciano Infelisi, according to the report in the Rome Daily newspaper, who was one of those bureaucracy-haters, tired of “unethical professionals” who believed that the public payroll was a lifetime annuity, he acted. (Don’t steups. I have actually heard a very, very senior member of our government calmly declare in Parliament that she had joined the civil service in TT because she knew she could never be fired. She then proceeded to take time off over the next few years, to run for political office.)

So Signor Infelisi appointed chief Gianni Carnivale of the Police Mobile Squad to investigate and find the lawbreakers. I swear on my mother’s grave I am not making this up. Even his name is real.

Within three months Carnivale found 90 doctors suspected of issuing phony medical certificates for sick leave for state and private workers. One physician, the head of gynaecology at Rome’s Palestina Hospital, was arrested for absenteeism himself, after signing in for hundreds of hours that he never worked. His hospital’s plumber was also jailed when they found he had been issued 90 days in sick certificates for installing the doctor’s home plumbing.

And so what does Section 77 in our law have to say about such behaviour? I quote: “(1) A worker, who by deception absents himself from his employment is liable on summary conviction to a fine of $1,000 or to imprisonment for six months."

Wow! And to go on: “(2) A Medical Practitioner who issues a medical certificate to any worker for the purpose of enabling the worker by deception to absent himself from his employment by means of the certificate is liable on summary conviction to a fine of $2,000 or to imprisonment for 12 months.”

Of course, the latter will be excused if, but only if, the medical practitioner may reasonably be considered to have acted for such purpose as specified in Section 2.

The prosecution’s case can actually use evidence that that doctor has issued such certificates to lots of other workers as well. You know, the doctors – and most workers know where to find them – who, as you enter their office, ask ungrammatically: “How much ah days you want?” When you say “seven,” usually he takes your blood pressure for show and then says, “Ok, that will be $140. Pay the receptionist on your way out.”

Actually, I may be statistically wrong there. It used to be $20 per day they charged. It may have changed since covid. You have to pay cash, since doctors don’t pay tax or leave a paper trail of such transactions.

But, but, but: please note two things: 1) in individual cases the doctor may defend himself with the claim that he “did not know, and had no reason to believe that the worker was going to use the certificate fraudulently.” And 2) the clause “on summary conviction.” No doctor, as far back as I can remember, has ever been summarily convicted on the charge of” fraudulently issuing medical certificates.” They are far too ethical, apparently, to do any such thing.

This is not Italy, after all.

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"That sick leave could land you in jail"

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