French authorities announce major reform to workers’ sick pay rules

French health authorities have announced major reforms to the rules on sick pay and leave, including more measures to detect false claims, as the number of people taking sick leave rises.

The changes are part of wider plans to bring down healthcare expenditure on people taking sick leave (arrêt de travail), which is predicted to reach €17 billion by the end of this year.

The Assurance maladie says its aim is to better “track” sick leave, but also offer more support for those who need it most. It is calling on politicians to overhaul the system, and make it “more sustainable…and fairer”.

‘Relaunch and amplify’ cost-cutting

It comes as the number of sick leave days rose in the first half of the year, with the cost expected to “increase by more than €1 billion” in 2024, reaching €17 billion by the end of the year, said director of the Caisse Nationale d'Assurance Maladie (Cnam), Thomas Fatôme, at a press briefing.

It is set to “relaunch and amplify” actions designed to cut needless costs, it said. Already in 2023, it cut costs by €200 million, Mr Fatôme said.

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New and stepped-up Cnam measures are set to include:

• Contacting all those who have been on sick leave for more than 18 months (around 30,000-40,000 people) to “check whether the leave is still justified”, or whether it is possible to adapt it by, for example, “taking part-time medical leave” or “organising a return to work”

• Writing to those who have had “at least two stoppages of less than two weeks” over a six-month period. The letter will “remind them of the rules” and offer “support” to get them back to work if they need it. This will not include those such as pregnant women or those with recognised, chronic, long-term conditions

• Contacting 7,000 GPs “who have fairly high prescription levels” to “see if they can contribute to better control of expenditure”. These will not be “checks”, but “a friendly exchange”, said Mr Fatôme

• Visiting around 1,000 companies with “very high absenteeism” to check that they are not creating “conditions” for work stoppages, such as poor working conditions or high accident rates

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‘A general review’ needed

Mr Fatôme has also called for “all players to be brought to the table [including government, parliament, and social partners]...to carry out a more general review of the system [and] make it fairer, more equitable, easier to understand, and more sustainable”.

He said that current complexities in the system mean that “some are not covered in the same way” depending on the size of company or how long they have worked there, and that “many people say they find it hard to understand how they are covered”. 

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He added that he was available to the government to help consult and contribute to this work.