House of Commons - Public Accounts

Select Committee on Public Accounts Fiftieth Report

THE MANAGEMENT OF SICKNESS ABSENCE IN THE METROPOLITAN POLICE SERVICE

ACTION TO COMBAT LONG-TERM SICKNESS ABSENCE

27. The National Audit Office's examination showed that long-term sickness is a particular problem.[28] MPS officers took nearly 397,000 working days off sick in 1996-97 compared with 320,000 days in 1991-92, an increase of nearly 25 per cent. Over this period the number of short spells of absence had fallen, and long-term absence had risen, with absences of more than 6 months accounting for 53,281 working days in 1991-92 and 103,107 in 1996-97.[29] Nearly two thirds of these absences were due to spinal/neck injuries (19 per cent); stress (19 per cent); other musculo-skeletal injuries (14 per cent); and injuries on duty (12 per cent).[30] Against these increases the MPS explained that it had more than halved the number of working days lost as a result of injury on duty, largely through an officer safety programme and improved equipment and training.[31]

28. Over the period 1991-92 to 1996-97, the National Audit Office found that the number of days lost as a result of stress, depression or similar conditions had more than doubled from around 2,000 to 4,000.[32] The MPS considered that the rise in stress-related absence was due to the wider acceptance in the police service and society generally that stress is a legitimate cause of absence. Also, a legal ruling in 1996 now meant that a claim on grounds of stress did not have to demonstrate any single trigger incident, which made it difficult to challenge a claim. The MPS had a programme to identify officers who might be particularly vulnerable to stress-related illness, for example because they were constantly dealing with victims of the most serious offences, and to offer them counselling and training in stress management. The occupational health support available to police officers and civilian staff was based on local needs and might include, for example, well-person clinics, group counselling or access to physiotherapy.[33]

29. The Association of Chief Police Officers recommends that forces should have one full-time equivalent occupational physician per 5,000 staff and one full-time equivalent occupational health adviser per 2,000 staff. The National Audit Office found that in the MPS the ratios were one to 14,500 and one to 3,000 respectively. The shortage of full-time occupational physicians meant that resources might not be available to carry out preventive tasks and to develop performance measures and clinical audit.[34] The MPS has since come into line with the Association's recommendation on occupational health advisers and is closer to that on occupational physicians, having increased the complements by seven occupational health advisers and two part-time occupational physicians respectively.[35]

30. The National Audit Office found that occupational physicians' ability to come to a fully informed judgement on the individuals referred to them was sometimes limited because line managers had not provided sufficient information.[36] The MPS agreed that line managers had been over-sensitive about patient confidentiality and may not have been sufficiently challenging in exploring with officers the reasons why they were sick. A new referral form now required both the line manager and the doctor to set out their expectations in terms of the reasons for the referral and what happened as a result.[37] The MPS had also ended the practice of allowing officers to refer themselves to its occupational physicians. All referrals were now through line managers, and they had to explain the reason for the referral.[38]

31. In handling interventions with sick staff the MPS considered that it had to respect their relationship with their general practitioner, who was the primary carer. However, the MPS was challenging medical decisions with increasing vigour where appropriate. It was currently recruiting a new senior occupational health physician who would have responsibility for health audit and monitoring GP interventions.[39]

32. The MPS told us that it would like more flexibility to be able to spend to save on health provision to get staff back to work, and thus to avoid long-term sickness or a medical pension. The Home Office told us that the Home Secretary would first need to look at the implications for the police service as a whole and consult with colleagues in Scotland and Northern Ireland.[40]

33. In September 1995 the Home Office introduced amended Regulations which envisaged police officers receiving half-pay following six months' absence in any twelve month period, and no pay after twelve months' continuous absence. However, the Regulations allow the Chief Officer in each force discretion to extend the periods of full-pay or half-pay. The National Audit Office found that over 1,000 MPS officers came within the new Regulations, but in more than 90 per cent of cases the Commissioner of Police of the Metropolis had exercised his discretion to provide for extended periods of full-pay.[41]

34. The number of officers on continuous sickness absence of over six months fell in the period leading up the change in the Regulations, but rose again shortly afterwards.[42] The MPS did not believe that this was conclusive evidence of abuse of the Regulations.[43] The Commissioner explained that he had felt unable to impose a six-month cut-off regardless of the availability of local health care, since much of the sickness related to musculo-skeletal injuries, and the waiting list for orthopaedic surgery in London was on average two to three months longer than anywhere else in the country. He also considered that taking officers off pay prematurely might have driven them into medical retirement, which could have added as much as £30 million to the annual budget. However, the MPS was reviewing its operation of discretion and expected the review to lead to changes.[44]

35. There are separate police regulations covering sickness absence, ill health retirements and disciplinary procedures. Of the 1,345 MPS officers who had retired on ill health grounds in the three years to March 1997, 67 had done so while in the discipline system. Of these, two had been awaiting a criminal trial and 17 had been awaiting a discipline board.[45] Disciplinary procedures took precedence over sickness absence, and the MPS could not intervene in relation to sickness or pay in such cases. The MPS felt that it would be helpful if such officers could be taken off pay, if appropriate, and if it were easier to secure attendance of uncooperative officers at disciplinary proceedings.[46] The Select Committee on Home Affairs had recommended reform, and the Home Office recognised that the regulatory framework needed updating. It was proposing to publish a consultation document on the Police Pension Regulations that would potentially be looking at very major change.[47]

36. The Home Secretary subsequently made a statement to the House on 25 March 1998 in response to the Home Affairs Committee's recommendations on police disciplinary procedures. He said that he would ask the Police Negotiating Board to consider and report back to him on the Home Affairs Committee's proposal that there should be provision for suspension of an officer on reduced pay pending discipline proceedings. He agreed that disciplinary proceedings could be concluded in the absence of an accused officer in any case considered appropriate, and endorsed the Home Affairs Committee's exhortation to Chief Officers to show a higher degree of commitment to using their existing powers to verify the genuineness of an officer's claimed sickness or disability. Chief Officers should ensure that the police authorities were aware of their powers to postpone agreement to a request to retire an officer on the grounds of ill health until the completion of disciplinary proceedings. The Home Secretary concluded that there was no implication that the vast majority of police officers who retired on ill-health pension were not genuinely sick. He fully appreciated that police officers were vulnerable to injury and health problems arising from the stresses of the job, and that they fully deserved the pensions which were awarded to them.[48]

37. Figure 2 shows that in the six years 1991 to 1997 medical retirements of officers in the MPS almost doubled to 457. The total cost of these retirements in 1996-97 was £26.25 million, an average cost of £57,000 for each retirement. Around half of all retirements are on medical grounds. In the police service, early retirement is financially advantageous to officers and correspondingly costly to the force.[49] For example, a constable with 15 years service leaving the MPS at age 35 with a life expectancy of 70 years would receive a lump sum and a deferred pension at 60 at a total cost to the MPS of some £87,000. If the officer left in the same circumstances but on grounds of ill health, the pension would be payable immediately and the total cost to the MPS would increase to some £266,000. If the same officer is injured on duty and given a 30 per cent disablement award, the total cost increases further to nearly £548,000.[50] The National Audit Office concluded that there was a risk that medical retirement arrangements might be influencing police officers' attitudes to the acceptability of taking long-term sick leave, and therefore be a factor behind its rise.[51]

Figure 2 Police officer retirements, 1991-92 to 1996-97

38. The MPS was concerned about the number of medical retirements, and agreed that there were too many, but did not believe that there was wholesale abuse. Because officers' pay and conditions were based largely on a pension after 30 years' service, an officer who might, for example, be suffering psychological problems as a result of policing had either to continue until pensionable age, or to seek medical retirement. The MPS believed other options were needed which would allow officers to go at an earlier point in their career, with dignity and a sensible financial award. The MPS had therefore suggested that there should be a comprehensive review of pay and conditions to address these issues.[52]

Conclusions

39. In 1996-97 the MPS lost nearly 397,000 working days to sickness absence by officers, an increase of 25 per cent since 1991-92. Much of the increase resulted from absences due to long-term sickness, which almost doubled to 103,000 working days a year in the six years to March 1997. This increase has a significant impact on the availability of officers for operational policing, and implications for future levels of medical retirements. The MPS could have acted earlier to tackle this trend.

40. Occupational health services have an important part to play in managing attendance, and the Association of Chief Police Officers recommends that forces should have one full-time equivalent physician per 5,000 staff and one full-time equivalent occupational health adviser per 2,000 staff. The MPS has recently decided to increase the resources available for occupational health to bring the force more into line with these recommendations. It is important that these resources are used effectively, and we recommend that MPS line managers should be encouraged to work closely with occupational health personnel and keep them informed.

41. We note that the MPS would like more flexibility to spend to save to reduce sickness absence, for example on occupational health provision. The MPS and the Home Office should explore how this can be achieved.

42. The MPS has chosen to exercise the discretion available to provide for extended periods of full pay in 90 per cent of all cases where officers on long-term sickness absence might have been placed on half pay or no pay. In conducting its planned review of this approach, the MPS should draw on the experience of those police forces which have reduced pay or stopped it altogether in a greater proportion of relevant cases.

43. In the three years to March 1997, 67 of the 1,345 MPS officers who have taken ill-health retirement did so while in the discipline system. Of these 67, two had been awaiting a criminal trial and 17 a discipline board. It is unacceptable that disciplinary procedures can be frustrated in this way. We therefore strongly support the recommendation of the Select Committee on Home Affairs that there should be provision for suspending an officer on reduced pay pending disciplinary proceedings; and the proposal, subsequently agreed by the Government, that disciplinary proceedings should be concluded in the absence of an accused officer in any case where it is appropriate.

44. In the meantime, we expect the MPS to act on the Home Affairs Committee's exhortation to Chief Police Officers to exercise their existing powers to verify the genuineness of an officer's claimed sickness or disability; and to ensure that police authorities are aware of their powers to postpone agreement to retirements on ill-health grounds until the completion of any disciplinary proceedings.

28 C&AG's Report paragraph 4.1 Back

29 ibid paragraph 2.11 and Figure 4 Back

30 C&AG's Report paragraph 4.5 and Figure 15 Back

31 Q 2 Back

32 C&AG's Report paragraph 4.6 and Figure 16 Back

33 Qs 2, 77, 106-107 Back

34 C&AG's Report paragraphs 4.10 and 4.13 Back

35 Q 7 Back

36 C&AG's Report paragraph 4.18 Back

37 Q 58 Back

38 Q 59 Back

39 Qs 15, 191 Back