(de-news.net) – Plans to require employees to present a medical certificate from the first day of illness, replacing the current rule under which certification is generally required only after three days, have triggered significant controversy within Germany’s governing coalition, exposing divisions. Critics question its effectiveness, healthcare impact, and consistency with efforts to reduce bureaucracy, as well as the broader implications of the proposed reform.
Senior SPD officials have questioned the proposal, arguing that it reflects unjustified mistrust of employees while failing to address the underlying causes of Germany’s comparatively high rate of sick leave. Anke Rehlinger, Saarland Minister-President and SPD Deputy Chair, maintained that although the country’s absenteeism figures warranted careful examination, requiring medical certification from the first day of illness was unlikely to represent the most appropriate policy response. She described the provision as one of the more problematic elements of the coalition’s broader reform package and warned that the measure could unnecessarily overcrowd physicians’ waiting rooms with patients whose conditions would be better managed by remaining at home, thereby creating additional pressure on primary care services without addressing the underlying drivers of sickness absence.
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Stefan Schwartze (SPD), the federal government’s patient commissioner, has likewise criticized the proposal, arguing that mandatory first-day medical appointments would impose unnecessary burdens on both patients and healthcare professionals while increasing the risk of infectious disease transmission. He also advocated expanding digital healthcare and telemedicine services as a more efficient means of supporting patients and cautioned that some employees might instead continue working despite being ill, delaying their recovery and ultimately contributing to longer periods of sickness-related absence.
Steffen Krach, the Berlin SPD leader, also criticized the plans, arguing that the coalition’s stated objective of reducing bureaucracy was fundamentally inconsistent with abolishing telephone-based sick notes while simultaneously introducing mandatory certification from the first day of illness. He maintained that family physicians had legitimate grounds for opposing the changes because they would place additional strain on medical practices, increase administrative workloads, and make it more difficult for patients requiring treatment to obtain timely appointments.
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Nicola Buhlinger-Göpfarth, head of Germany’s family physicians’ association, expressed similar concerns, characterizing the proposal as largely symbolic and unlikely either to reduce sick leave or prevent abuse. The German Trade Union Confederation echoed that assessment. Meanwhile, Dennis Radtke, chairman of the CDU labor wing, questioned whether the political controversy generated by the proposal was proportionate to the improvements its supporters expected it to deliver.
Telephone certification was first introduced in 2020 during the COVID-19 pandemic under Health Minister Jens Spahn, later suspended, and permanently reinstated under Health Minister Karl Lauterbach in December 2023. Supporters of the new measures within the CDU/CSU have also defended the changes by citing concerns about fraudulent medical certificates, including allegations that large numbers of sick notes have been issued by physicians operating from abroad.
This week, the coalition committee of the CDU/CSU and SPD agreed that employees should in future submit certificates of incapacity for work from the first day of illness, although the precise details of implementation have yet to be determined. The compromise emerged after the SPD accepted the abolition of telephone-issued sick notes together with the earlier certification requirement in exchange for the CDU/CSU abandoning its original proposal to introduce unpaid waiting days at the beginning of a period of illness.
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