One of the things that always bothered Leo Varadkar when he was a practising GP was the number of patients who couldn’t afford to take a day off work.
They’d turn up at his surgery, ask for some medicinal cure-all and, despite him advising them to rest, they’d go straight back to work.
It struck him how they were so hard up they would rather do that – and risk infecting other workers – than go without being paid.
Fast forward to today, and the former St James's Hospital and Connolly Hospital junior doctor is now at the helm of Ireland’s first statutory sick pay scheme.
The Irish Congress of Trade Unions (Ictu) and the likes of Cork People Before Profit TD Mick Barry have been campaigning for years for a statutory sick pay scheme.
If all the legislative hurdles pass through the Oireachtas this year, it will be in place some time in 2022 and it will see workers getting 70% of their daily wage for, in the first year, the first three days off sick.
They will, however, need to produce a sick cert from their GP, and they have to have been working for the company for at least six months.
When the Government approved the drafting of the General Scheme of the Sick Leave Bill 2021 in June, the Employment Minister described it as “part of the pandemic dividend”.
“It’s not right that people feel forced to go to work when they are sick and it’s not good for public health,” he said at the time.
Asked about his own personal motivation behind his involvement in the scheme, he told the: “As a doctor, I frequently had patients who could not take time off when they were sick as they could not afford to lose a few days’ pay.
"This always bothered me as it delayed their recovery and, when they had an infectious disease, they risked spreading the illness.
“In other jobs, in some cases, they could have been a safety risk to themselves and others if they were unable to focus on their work due to pain or fever while operating equipment.”
There are those who believe the scheme either goes too far – or not far enough.
And regardless of which side you are on, both sides agree there could well be unintended consequences to it.
Ictu’s head of Social Policy and Employment Affairs, Dr Laura Bambrick, said the scheme was “decades overdue”.
“Unfortunately, it took a global pandemic for politicians in Ireland to commit to bringing in this basic workers’ right,” she said.
“As a result of the Ictu’s public awareness raising campaign on a root cause of Covid-19 outbreaks in meat plants and our successful calls to make sick pay mandatory, legislation will be introduced.”
She added: “This legislation has overwhelming public support.”
However, among the unions’ reservations about the incoming scheme are concerns about the requirement that not only should an employee be working for six months before they can qualify for sick pay but that they also need a GP cert.
“This has the potential to incentivise some employers to opt for casual employment contracts to avoid their obligation under the legislation,” she said.
“Ictu is concerned that this cost will create a barrier for workers exercising their new right to paid sick leave.
“We will be lobbying for an amendment to the bill at committee stage to have a number of the sick pay days ‘uncertified’ as a work around to our lack of free basic healthcare."
Mick Barry TD also has his own reservations.
His campaigning on the issue of sick pay includes raising issues in 2005 over subcontracted migrant workers involved in Cork City’s major regeneration projects.
"Fine Gael have trumpeted the new sick pay scheme as a sure sign they are in the workers' corner,” he said.
“But the unfortunate reality is this scheme can't hold a candle to those enjoyed by workers in some other European countries.
"In Germany, a worker will receive 100% of their wages for the first six weeks, whereas in Ireland it will be a mere 70% of salary for the first 10 days in a few years.
“I think this rule should be scrapped."
According to the Government, the 70% sick pay rate and the daily cap are to ensure “excessive costs” are not placed solely on employers, who may also have to deal with the cost of replacing staff out sick at short notice.
It says the bill is primarily intended to provide a “minimum level of protection” to low-paid employees, who may have no entitlement to company sick pay schemes.
The fact it is being phased in over four years is, the Government also says, a sign it is taking what it describes as “a balanced approach to plug a well acknowledged gap in our social protections”.
And it says it is doing this while also responding to the “cost concerns of small businesses in the current economic environment”.
The Irish Small to Medium Enterprises Association (Isme) is, like Ictu, in favour of a statutory sick pay scheme but its members have reservations.
Chief executive Neil McDonnell said: “Employers are paying 11% PRSI for a really low set of benefits.
“We agree employers' PRSI is low by comparison with European norms.
“And while employers pay 11% into the fund uncapped, the benefits from that are all fixed.”
He says high social benefits make it "very hard, very expensive" to employ people.
“What we would worry about is, in Geneva, they have a really weird social problem over there in that none of the blue-collar workers in Geneva can afford to live there.
“So we have to be very, very careful about the cost of living and the cost of employment because as you ratchet that up, you make it much more expensive to employ people.”
A fisher, whose income is derived entirely from their share of the fish caught on each trip, told thethey will not benefit from the scheme.
“Only the really big boats have protections for its fishermen,” they said.
“Basically, if you are off sick, it’s just tough luck.
“Most trawler owners can’t afford to pay anything else.”
Mary Watters, regional manager with North Dublin Citizens Information, provides information, advice and advocacy on public and social services.
The Citizens Information Board provides the Citizens Information website, citizensinformation.ie, and supports the network of Citizens Information Centres and the Citizens Information Phone Service.
It also funds and supports the Money Advice and Budgeting Service (Mabs), the free, independent and confidential service for people who are in debt or at risk of falling into debt.
“We would get people from all walks of life," Ms Watters said.
“Probably the more difficult ones are the people who would be considered to be on better incomes and have a better standard of living.
“When they hit roadblocks in their life, they are often less prepared for them.
“Many of them have no experience of having to manage with less money.
“People who have encountered difficulty all their lives have had to access the welfare system earlier on in life and tend to be better equipped to deal with challenges that hit them. Sickness and terminal illnesses don't choose which income bracket to hit. They hit across the income bracket."
She said the new scheme would help alleviate the hardship for people in the opening days of an illness.
“Many people just don’t realise there is far more supports out there than they realise.”
The Department of Social Protection spent €593m on standard illness benefit in 2020.
On top of that, enhanced illness benefit – for people either diagnosed with Covid-19 or who are a “probable source” of infection of the virus – was introduced in March 2020.
Expenditure on the enhanced illness benefit was €57m in 2020.
Some €68m was paid out from January to the end of September this year and is expected to be about €84m for all of 2021.