'Less people with long-term illness? No stigmas, but cooperation and consultation'

Harsh statements like “hunting down the sick” and “fraud hotlines to report doctors” have been echoing in recent weeks as criticism of the new measures around long-term disability. Understandable, as changes always evoke strong emotions. But unfortunately, this polarisation also sets the tone for further debate. This is unfortunate because it mistakes the seriousness and complexity of the problem. If we really want to get the number of people with a long-term illness down, we cannot stigmatise companies, doctors, and the sick employees, but get them to work together.

The reality remains that sick leave in Belgium is rising year after year, both short (<1 month), medium (1 month to 1 year), and long-term (>1 year). The cost to our society is gradually becoming unmanageable. With an ageing workforce, the risks are only increasing. Not intervening is no longer an option.

In its plans, the government is indeed opting for more follow-up and accountability – of employers, employees, doctors, regional employment services, and health insurance companies. That in itself is already a step in the right direction. Yet in the public discussion, it is mainly the negative elements, such as control, sanctions, and fraud hotlines, that linger. Thus, the fundamental positive message – encouraging cooperation, strengthening prevention, and supporting reintegration – risks being lost.

Multidisciplinary collaboration

Employers are framed as being controlling and snitching, and treating physicians as being lazy. That picture is unfair and insufficiently nuanced. Yes, many companies still have steps to take in terms of structured policies around work resumption and absenteeism prevention. Equally, it is incorrect to polarise treating physicians as if they treat sick leave lightly. The vast majority act according to their professional deontology, with care and responsibility. What they are sometimes lacking is more the time and knowledge to take an active role in complex reintegration processes. The strength of the new plans lies precisely in the call for cooperation: early consultation between employer and employee, involving treating physicians, bringing in occupational physicians, and back-to-work coordinators, and activating regional employment services. This multidisciplinary approach is not only necessary, but the only right way to go.

Support instead of stigma

People with a long-term illness deserve support, not stigma. Doctors deserve trust, not suspicion. And employers deserve partners, not distrust. But at the same time, we must recognise that the current system is creaking under its own weight, and doing nothing is no longer an option.

Let us therefore depoliticise the debate and move beyond slogans. Polarisation may mobilise for a while, but it does not bring a lasting solution. Let us not reduce the action plan to terms like “hunt” or “fraud hotline”, but recognise that a broad movement is needed, in which shared responsibility, solidarity, and prevention go hand in hand. Nuance is needed. But equally, we need to spring into action together.