Broken bones but no medical leave

Posted by on July 21, 2013 in Articles, Facts, research, analysis

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The above are file pictures and do not represent any of the workers mentioned in this article

Foreign workers with relatively serious injuries get very little medical leave when their employers send them to private hospitals. From a recent survey (15 July 2013), we came across one worker (Case ref  094) who had a broken foot, and yet was given no medical leave. Two others (Case ref 904 and 633) had broken bones in their thumbs or fingers; they too didn’t get any medical leave.

Like these three men, most workers first seen at private hospitals are soon dissatisfied with the treatment they are getting from there, and soon after make their way to a public (also known as ‘restructured’)  hospital, even over their boss’ objections.

In a recent article, Nearly one in three accidents may not have been promptly reported, results from a survey (done on 5 July 2013) of 148 injured workers were presented. Of these, 62 were sent by their employers to a private clinic or private hospital, and more than two-thirds of these 62 were given three days or fewer of medical leave. When they subsequently showed up at public hospitals, these workers were given an average of 94 days of medical leave.

It was soon realised that the survey should have asked workers to indicate the nature of their injury. Were they really serious injuries? Were private hospitals under-prescribing medical leave, or were public hospitals over-prescribing? While non-medical professionals aren’t able to be the judge of that, most laymen will have a sense of what sounds like a serious injury and what does not.

This oversight — not asking workers in their survey to describe their injuries — largely came about because TWC2 volunteers see the men and their injuries every day. They know what one means by ‘injuries’, but they do not realise that an uninvolved person just reading our survey results may not have the same mental picture.

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Supplementary survey

Consequently, it was felt necessary to do a supplementary survey. We didn’t need a large one, just one with a reasonable sample that would give us an idea of the kinds of injuries they suffered and the numbers of MC days they were given by (a) private hospitals and (b) public hospitals. It would help readers make a better connection between the severity of the injuries and the response of private and public hospitals.

survey_2013-07-15thumbnailWe also asked workers whether they needed to undergo an operation. If they did, it would be another indicator that the injury was a serious one.

The survey was conducted on 15 July 2013, with 37 respondents — men in their twenties and thirties from Bangladesh and India. We only surveyed workers who had first been referred to a private hospital after the work accident. Those who were sent directly to a public hospital or polyclinic were excluded from the survey.

A full table of the results can be seen by clicking the thumbnail at right.

The table will show that the kinds of injuries they suffered varied quite a bit, but there were many cases of broken bones and amputations. There was also a man with an eye injury and another with abdominal injury. At least to laymen, these seem like injuries that would need considerable time to heal.

Thirteen of the 37 needed surgery (including one who is still waiting for it). Eleven did not undergo surgery. Thirteen other workers did not give an intelligible answer to the question — perhaps they themselves were not clear what hospital procedure would count as an ‘operation’.

survey_2013-07-15piechart

More than half of the 37 men surveyed (22 of them) were given three days of medical leave or less by the private hospital they were sent to — the green portion of the pie chart. All except one of these 22 men subsequently made their way to a public hospital, where they got an average of 89 days of MC.

Even among the 15 who got more than three days of MC from the private hospital they were sent to — the orange slices of the pie — nearly half of them got just four or five days.

Isolating the 13 cases whose injuries needed surgery, we find the same pattern. They received an average of 3.8 days from private hospitals. When they showed up at public hospitals, they got an average of 87 MC days.

The pattern revealed by this survey is similar to that from the first survey. That is, there is a big difference between the number of days of medical leave issued by private hospitals compared to public hospitals. What this second survey adds is some indication that the injuries aren’t light. In fact, many involve bone fractures and one in three requires surgery. Both sets of survey results lend support to the argument that TWC2 has made for a long time: that private hospitals appear to be influenced by employers in minimising the length of medical leave. It is a matter that even the government’s attention has been drawn to, as evidenced by a circular letter issued last month to all medical practitioners by the Ministries of Manpower and Health. See the news posts: Doctors told to give injured workers enough leave (7 July 2013) and Don’t dictate sick leave, employers told (21 July 2013).

TWC2 is an organization that is dedicated to assisting low-wage migrant workers when they are in difficulty. We are motivated by a sense of fairness and humanity, though our caseload often exceeds our
means.

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