Here Lawrence delivers part of his HSE UK talk during which he details the dangers of presenteeism and how businesses can start to deal with it in the workplace. In addition to this video from Lawrence Waterman, we also have an article that looks at the subject in a little more detail.
About Lawrence Waterman
Lawrence Waterman OBE is one of the key content ambassadors for the HSE Network and has supported the community through videos and the HSE Global Series conferences. Lawrence has experience in both the British Safety Council and senior positions in IOSH.

Transcript
So we’ve got absenteeism, presenteeism, leaveism, lots of these terms. And over the next few months, I suggest that you just have a look at CIPD’s website, some of the discussions. If you Google presenteeism, you’ll get different definitions.
Essentially, for many years there has been an argument that either because work is challenging and difficult for people at different times or because they’ve got other things going on in their lives that mean that work is not something they can cope with, we have people absent from work.
And HR practitioners have put in place regimes to do return to work interviews, to track people’s absence from work and make it a disciplinary offense if they’re absent for more than a certain number of days without, you know, doctor’s notes, good cause, all of that.
We’re fairly clear, aren’t we, that there are systems that drive people to attend work. But what’s been happening much more recently is an understanding that even more people than are absent from work and are subject to those regimes attend work but are not in a mental and physical state to work productively and normally.
And indeed if the state that they’re in when they present for work is seriously compromised, even their journey to work and their presence at work during a normal working shift could make them worse from whatever mental or physical condition they’re suffering from.
Now, this is not an argument against people with low level mental ill health or recovering from mental health episodes, not finding the workplace a comfortable haven and a place where they continue to rehabilitate. This is not an argument for saying that if you’ve got back pain from a low level back injury that remaining mobile and active including going to work but with some adaptations of a considerate employer is not a way in which you will make a better, long-term, lower pain, more rapid recovery.
What it’s saying is that hidden in the statistics around presence and absence, there are people who are not able to work effectively and productively because of their health status, mental, or physical, or a combination of the two.
And the organizations that don’t recognize that, don’t recognize that there is a productivity gap that is created that is greater than that caused by absenteeism. And all the efforts, the management plans, those systems that had been put in place to deal with absenteeism because it affects the normal operation of the organization, those arrangements would be matched by arrangements to address presenteeism if employers more universally recognized its significance to their organization and the pressure it puts on the colleagues of the people that do come into work because they feel they have to.
Now there are a whole range of reasons why people come into work when it would be better if they didn’t. So it wouldn’t take very long to ask people, let’s say, in the Brighton area where there’s a GP medical center that’s been closed down and a hospital where two of the A&E workers have now been identified positively as exhibiting the symptoms of Coronavirus.
If you ask colleagues, “If I’m feeling a bit fluey, if I’m beginning to exhibit the symptoms of Coronavirus, should I still come into work?” And there’d be lots of people that would say, “No, no, no because if you come in and we end up with a few people getting those symptoms, we’ll end up with a whole…and it will be a disaster. You know, we’ll end up being transferred to a cruise ship off Taiwan and stuck there for a couple of weeks. We don’t want you to do that.”
But of course, it isn’t normally presented in quite such stark and obvious terms that the person who’s turned up unfit to work is prejudicing the fitness of colleagues and or, and we know this, statistics are clear, people who are a bit under the weather mentally or physically are more likely to have an accident because they’re more likely to exhibit one of those human errors, five every three minutes or whatever it was from the earlier presentation.
You make mistakes. One example of that, on the Olympic Park, we did some research, simple research, have you had breakfast today? Very simple research. And we found that over 85% of the workers that turned up to work physically hard on a construction site are also people who in global terms are relatively low paid.
When you consider that they’re working away from home and they have to provide digs, they’re eating away from home and even takeaways are more expensive than buying fresh food and preparing it yourself, but often staying in digs with no catering facilities, they weren’t having breakfast.
And we ended up with a campaign that resulted in the catering units, the canteens on site, offering cheap porridge, a pound for a pot of porridge with different toppings, you know, honey, nuts, raisins or whatever. It resulted in people that didn’t like porridge joining their mates going to the canteen and at least having a piece of toast and a cup of tea.
Porridge is quite good because it’s slow-release carbohydrate and helps keep you going during the day. Now if you don’t have breakfast, and then you’re working quite hard, and you think back and actually, the last thing you ate was a takeaway at 6:00 the evening before on your way to your digs from your site, you’re going to be suffering from low blood sugar.
And we had a rash of early to mid-morning accidents, you know, simple things, electricians putting screwdrivers into the palms of their hands, just being clumsy. And if you look at the data, it says that low blood sugar can influence your ability to concentrate, to focus, to…you know, thinking about all that mindfulness stuff of being in the moment of the job that you’re doing.
So we had a health and safety reason for wanting people to have breakfast. But our health colleagues said, “Actually, if you don’t eat and then you eat a lot, big lunch, big fry up or whatever, and then you don’t eat again so that your blood sugar is peaking and troughing in the course of 24 hours, it predisposes you to develop diabetes, which screws up your ability to manage sugar in your bloodstream more generally.
And it’s a long-term health problem that results in, you know, amputations, loss of eyesight. And it’s debilitating, you end up being effectively a disabled person. The point I’m trying to make is that if you think about the drivers for people coming to work when they’re a bit under the weather, they don’t get paid if they’re not there, true for a lot of construction workers, they’re worried about their colleagues thinking that they’re not reliable, that they’re not decent people, “There’s a rush order this week and I’ll be letting people down.”
“The job I do is important and I really need to be there to do it.” “I’m not sure my job is that secure and if I have a bit of absence maybe I’ll be the first out the door if they do a bit of downsizing in this company.” There are all sorts of reasons why people end up being driven to come into work when they shouldn’t really.
But it’s the same argument in reverse when you think about inappropriate absenteeism, where people are not engaged enough in the work so they get a slight pain in their back but their head’s making the decision, “This is significant enough for me to stay in bed.” So it becomes the same argument about how good is the workplace?
How attractive is it? But how honest can you be about your ability to work normally and properly during the working day if you turn up? And the data says that this is costing UK PLC billions of pounds a year in lower productivity.
And we’ve got amongst the worst productivity figures for the whole of the European Union. It’s one of the reasons why some people are keen on us leaving because there’ll be fewer of those negative comparisons [inaudible]. So people coming into work when they’re not fit and healthy, when you know that they’re a bit under the weather or they’re a bit quiet when they’re normally chatty, they’re a bit noisy when they’re usually quiet, so it might be mental, not just physical.
The signs might be quite complex. This is the outcome. This is what people do when they’re not fit for work. Now this isn’t an argument for saying everyone should be on a three-day week and paid twice the wages.
It’s saying that if you’ve got a workplace that is adversely affected by 5% or 10% of your workforce forcing themselves in rather than properly looking after themselves and coming in fit and healthy, the productivity hit that you’re taking is closer to 20%. This isn’t a presentation that ends up with a magic wand about what needs to be done.
It’s saying that if we begin to recognize this as a productivity issue to do with having a healthy workplace, which includes honesty, people being able to talk about the situation that they’re in, the support they might need, the adaptation that might be required so they can come into work when they’re slightly not fit but are able to work okay.
And when I remember situations that were relatively new at the time, of having conversations with pregnant women who wanted to be able to flex their hours so they weren’t battling in the London rush hour to get into work at the time that they were expected to attend, and ditto, expected to leave.
So this is about an argument…I suppose it relates to what I was saying earlier in that challenge question and answer session about there are some value drivers about making workplaces more decent for everyone to do with what kind of people do we want to be and how do we want to treat our colleagues?
But this is a business driver that’s pushing in the same direction and saying that if we cosset our workforce a bit more, and look after it a bit more, and create workplaces that are physically and mentally a bit more comfortable to be in, we might begin to tackle this presenteeism productivity glitch. Because the thing is that when people turn up and aren’t working efficiently and management doesn’t know that that’s the case, they don’t make substitute arrangements to ensure that that rush order still gets dealt with.
So this is a productivity loss that might be measurable in gross terms but supervisors and managers don’t have access to the detail that would enable them to do something about it this morning in their work team in order to address it. So in a way, it’s the same argument for daily activity briefings which are now become widespread in construction that were largely introduced around about 2000 to 2005, 2006.
They’re relatively recent. If you make a daily activity briefing, a lecture from the supervisor for five minutes about how the work’s supposed to be done, A, it’ll be a bit boring because they’ll be saying the same thing all the time, and B, you’ll be missing an opportunity because the workers won’t have the opportunity of feeding back on things that are in the way of getting the job done properly.