Letter to Minister of Labour on Amendments to Bill C-3

Sent by email to [email protected] on December 1, 2021

Dear Minister O’Regan,

On behalf of the Decent Work and Health Network, we wish to congratulate you on the introduction of 10 paid sick days for federally regulated employees. As our experience with COVID-19 has demonstrated, paid sick days are essential for the health of individuals, families, communities, and our economy.

We are a group of doctors, nurses, health workers and experts that have been at the forefront of the movement for paid sick days as a public health measure. Our organization has repeatedly presented evidence-based recommendations for effective paid sick leave policy.

To further support the effectiveness of your policy and ensure the purposes are met, we recommend the following amendments to Bill C-3. These recommendations are backed by health workers and experts across the country.

Necessary amendments to Bill C-3:

1. Leave with pay (s 239 (1.2))

Paid sick leave must provide an adequate number of days for our patients to stay home when they are sick. A U.S. study found that workers with 6 to 9 paid sick days accessed more preventive services than those with 0 to 2 days. At least 10 permanent paid sick days has become widely recognized as a minimum standard for adequacy across Canada.

While Bill C-3 rightly provides for 10 paid sick days, those sick days are not immediately available. This means workers do not have adequate protection at the beginning of the year or when starting a new job. Rather, employees accrue eligibility for sick days at the beginning of each month, after completing one month of continuous employment.

This system of earning paid sick days contradicts medical evidence and public health recommendations to stay home when sick at the first sign of symptom and until the individual has recovered. We are concerned that workers who get the flu, COVID-19, or another illness during the first few months of the calendar year would only be able to take one or two days instead of the true number of days of paid leave needed to recover.

A 2019 survey of 182 physicians found that they recommend patients with influenza-like illnesses stay home for a median of 4 days. For an upper respiratory tract infection (including the common cold) and gastroenteritis (including symptoms like vomiting and diarrhea), physicians advise patients to remain home from work for a median of 2 days. For all conditions, a substantive portion of physicians advise patients to remain at home until the fever has resolved. 2 And for COVID-19, public health recommendations can require individuals to isolate for 10 to 14 days.

The Yukon Territory is the only jurisdiction that uses an accrual model for access to sick days. All other provinces and territories provide access to the full number of sick days (paid or unpaid) immediately following the prescribed period of continuous employment. In Ontario, workers can access their full entitlement of paid sick days after two weeks of continuous employment. None of the other leaves provided for in the Canada Labour Code require that entitlements be accrued on a monthly basis. Paid sick leave should follow this practice.

Accessing paid sick days on a monthly accrual basis will negatively impact those in their first year of employment. In particular, this will be a barrier to accessing adequate paid sick days for those in temporary and insecure employment, who are disproportionately racialized and immigrant workers, and less likely to be employed continuously for one year. The accrual model will also disproportionately impact women who access more paid sick days than men. For women, the average number of days lost per year for illness and disability was 11.5 in 2020, compared to just 8 for men.

Paid sick days as a public health intervention will only be effective if an adequate number of days to recover from illness is available to all workers at the first sign of symptoms. That means no monthly accrual model.

We recommend that Bill C-3 (s 239 (1.2)) be amended to provide full access to 10 paid sick days after two weeks of continuous employment.

2. Certificate - leave with pay (s 239 (1.6))

Allowing employers to require a medical certificate from a health provider would create barriers to access and pose risks to our healthcare system. A worker would need to leave their home while sick, travel
through their community, expose a clinic or hospital waiting room to their infection, and sometimes pay for the sick note. Not only does this put the public at risk but it also deters workers from accessing this essential protection. According to a national poll, 82% of Canadians would rather go to work sick than get a sick note.

Bill C-3 introduces an onerous requirement for sick notes that would undermine the intent of the new sick leave provision. It includes a provision enabling employers to require an employee to provide a certificate issued by a health care provider certifying that the employee was incapable of working during the sick leave with pay (s 239 (1.6)).

There is widespread agreement in the medical community that sick notes are barriers to access for patients and an avoidable burden on healthcare resources. The Ontario Medical Association (OMA) concluded that “requiring patients with isolated illnesses to visit their healthcare provider may in fact delay their recovery by impeding their rest, and potentially expose them to additional contagious viruses.” The Canadian Medical Association (CMA) warns that “writing a sick note is added administrative work - time that should be spent providing direct care to patients.” Allowing employers to require sick notes is unnecessary, delays recovery for sick workers, worsens emergency department overcrowding, and wastes healthcare resources.

In fact, when the Ontario Liberals legislated Bill 148, Fair Workplaces, Better Jobs Act, 2017, which included 2 paid days of personal emergency leave, the provision for employers to require a certificate from a qualified health practitioner was removed. Jurisdictions across the country that introduced COVID-19 related leaves also followed this best practice. The Leave Related to COVID-19 for federally regulated employees also does not require a certificate from a healthcare provider. We must extend these best practices beyond the pandemic and ensure seamless access to paid sick leave for all workers.

We recommend that section 239 (1.6) be removed from Bill C-3. That is, remove the provision that enables employers to require a health provider’s certificate when accessing the new 10 paid sick days program.

We hope that you will carefully consider the above recommendations and introduce amendments to Bill C-3. In doing so, you will set a standard for provinces and territories to follow. Bill C-3 could be model legislation for effective paid sick leave policy across the country.

As health providers leading the fight for paid sick days, we are excited that our patients working in federally regulated sectors will have the opportunity to access permanent and adequate workplace protections and we look forward to the amendments.

Sincerely,

Denise Martins

Coordinator, Decent Work and Health Network