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Will post-pandemic culture finally stop us working while we’re sick?

The pandemic has provided an opportunity to change the toxic work cultures of the past.

By Harry Clarke-Ezzidio

The laptop on the kitchen table is always switched on for Dan Hough. “And no matter how often I tell myself ‘I’ve done enough work’, it doesn’t really work – there’s still always more work to do.”

Though Hough, a university professor, admits to being “an obsessive”, this way of operating even extends to when he is sick. “I find myself at 9pm in bed reading undergraduate dissertation plans,” he admits. “And that’s alright for me… But it’s not alright either; I’d be there with a sniffly cold, and I’ll still be in bed doing it.”

People working while ill is a familiar concept. Back when people faced packed morning commutes, it was quite common to see someone dragging themselves into work, coughing and spluttering, when they should clearly be off sick. 

This is known as presenteeism and it’s just as common as a cold. A Chartered Institute of Personnel and Development (CIPD) survey from just before the pandemic hit in 2020 found that 89 per cent of respondents reported presenteeism in their workplace, while less than a third of companies were actively taking steps to address such issues. Similarly pervasive is “leaveism” – the act of doing work-related tasks while off sick or on paid holiday.

“I would’ve definitely been the person who was coughing and spluttering on the train two years ago,” says Hough. After losing the structure of his 90-minute commute to and from work every morning and evening, he feels like he has constantly been “playing catch-up” since working from home began. “I’m not really playing catch-up. I still get stuff done,” he says, “[but] I had to find ways in my head to justify the fact that I had three hours of my working life that wasn’t there anymore. And the natural tendency for me was to overcompensate.”

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Many of us have felt a similar need to overcompensate as office life merged into our collective homes. High levels of presenteeism have persisted even while people have been working remotely: in the CIPD’s 2021 report, 84 per cent of respondents observed presenteeism, with 77 per cent of those working from home reporting presenteeism within their organisation.

Perhaps the most notable fact from the CIPD data is that more people reported instances of presenteeism in their workplace (84 per cent) than instances of time off through stress (79 per cent), the most common cause of workplace absence.

“That doesn’t really surprise me,” says Gwen*, who works in a communications role for the NHS. ”I think a lot of people are just thinking to themselves, ‘I may as well not fall behind’.” Gwen adds that not only would she feel “guilty” for taking time off, but that the stress of potentially falling behind would make her “more ill in the long run”.

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***

The cause of presenteeism is no mystery: in a demanding office culture, heavy workloads, high expectations and strained resources result in overworked and overstretched employees – trends that are exacerbated by general job insecurity.

But while presenteeism may be commonplace, that doesn’t make it less serious: it can lead to more adverse forms of illness, including depression, burnout, anxiety and stress. And for what? Unsurprisingly, research has shown that people are less productive when working while ill. And of course, people who turn up to work when unwell risk infecting their colleagues.

In the early, pre-lockdown days of the pandemic, the risks of encouraging people to come into the workplace no matter how ill they were suddenly took on new pertinence.

“The pandemic has really brought into sharp focus the dangers associated with presenteeism,” said Rachel Suff, senior policy advisor at the CIPD. “It’s not good for productivity or your performance if you go into work – which is what it used to be defined as – when you’re ill; you could spread [illness] around, you could make yourself worse, and end up taking more time off [using] sick leave.”

However, once lockdown was imposed and people adapted to working from home, the old in-person brand of presenteeism morphed into something even more pervasive. Remote working has exacerbated a trend towards an “always-on” working culture that was already inching its way into our lives. Now that our homes are our offices and our offices are our homes, it is harder than ever to switch off from work. With work emails at every time of the day and night and no physical delineation between office hours and leisure time, presenteeism has finally made itself welcome in our collective homes, says Suff. “It’s not technology itself that’s the problem, it’s the culture and organisational issues like workload and expectations, and whether those objectives set for employees are realistic,” she says.

“The bottom line is that we need to work smarter – not longer and harder, necessarily. And I think that raises all kinds of issues about management and leadership in organisations as well.”

***

So, how did we get to a place where employers and employees alike accept such a toxic working culture that allows presenteeism to thrive? 

The current state of affairs can be attributed to both philosophical and practical causes. The rise and embrace of neoliberal economic policies in the Eighties – and its solidification in the Nineties – has had an adverse impact on labour conditions. The economic agenda driven by Margaret Thatcher and Ronald Reagan pushed free-market economics, and, in turn, crushed the powers of trade unions, which held a key role in protecting workers’ rights. Academics Robert G Blanton (University of Alabama) and Dursun Peksen (University of Memphis) argue that the prevalence of “business-friendly” regulation and the culture of small-statism that are associated with neoliberal ideology all contribute to the “consistently strong, negative relationship between neoliberal policies and respect for core worker rights”.

This affects more than just work environments. “I think that neoliberal drive even infects the kind of micro-level cultures people have, where they feel they must be churning out things,” says Stuart Haw, a PhD candidate studying management. “And I think it comes from the top with the government.”

Haw believes that many Western governments, including the current Conservative administration in the UK, see neoliberalism as the best philosophy to follow, whereby “solutions will arise” naturally in response to societal problems (irrespective of whether those problems are, ironically, caused by neoliberalism itself). “Yet, for the last 30-40 years, we’ve seen all the problems that arise from that [thinking] – inequality, discrimination, physical and mental health issues – getting worse,” Haw concludes.

Presenteeism can affect people across any profession, but in certain sectors, the problem may also be self-perpetuating. In creative and academic spaces, for example, people are used to sparks of inspiration and having to work at odd hours on top of their “normal” working times. This raises a circular question: are the people who work in such fields more naturally inclined to be overzealous with their working habits? Or are they products of their environment, which is embroiled in a work culture and feedback loop that makes people feel like they need to go above and beyond to survive?

“I think it’s definitely a bit of both, to be honest,” says Gwen, who recently joined her communications role in the NHS after graduating from university. “I’m so conscientious and I never really tend to switch off”. Though she has not turned up to work when ill herself, Gwen has found herself leaving her laptop open after work, just in case she gets an urgent email relating to the pandemic: “You never truly switch off – especially when you’re working for the NHS,” she says.

Finally, there is a practical factor that plays a major part in the prevalence of presenteeism, particularly in the UK: low levels of statutory sick pay (SSP). The reality is that many people – especially those on part-time or casual contracts – simply cannot afford to rely on sick pay if they fall ill (something the government did not seem to take into account when demanding people self-isolate if they tested positive for Covid-19 or had come into contact with someone who had).

Today, SSP in the UK stands at £96.35 per week. Those earning less than £120 per week are not eligible for it at all, leaving an estimated two million people without support. “That’s how hard-pressed a lot of people are in this country. There’s a lot of in-work poverty,” says Suff.

***

After years of pressure from various groups, we are beginning to see organisations actively taking steps to tackle unhealthy work practices.

The 2021 CIPD report reveals that the proportion of organisations taking steps to address presenteeism rose in comparison to last year (45 per cent in 2021, versus 32 per cent in 2020), while more generally there was a fall in those who reported that their organisation is “much more reactive than proactive” on health and wellbeing (27 per cent, down from 41 per cent last year).

“It shouldn’t have taken a global pandemic to push people’s health and wellbeing to the top of the corporate agenda as a critical business continuity issue,” the foreword of the 2021 CIPD report reads. Indeed, it is mutually beneficial to both organisations and employees for toxic practices such as presenteeism to be consigned to the past.

“The proof will be there for companies to see,” says Suff, who believes many senior figures within organisations have “seen the [positive] link” between employee wellbeing and business prosperity.

So while the pandemic has drastically changed our practical working structures, has it also given us a unique opportunity to confront our toxic work culture?

It’s still too early to tell as restrictions begin to ease, many say. But the realisation that employee wellbeing is a “business continuity issue”, as the CIPD report puts it, may be a catalyst for change, even if it is not the moral epiphany many would have hoped for.

After a year of working from the (dis)comforts of home, it is clear that protecting employees – who, in sickness and in health, collectively kept organisations going from their homes – from the dangers of presenteeism is key to a better workplace and workforce.

*Names have been changed on the request of anonymity