European governments are moving to crack down on soaring workplace sick leave, with German Chancellor Friedrich Merz leading the charge after announcing that workers will need a doctor's certificate from the very first day of any illness — obtained in person — as part of a sweeping package of 34 economic reforms unveiled last week.
The sick-note measure was just one item in a broad "big bang" reform agenda that included pensions, tax cuts and housing affordability, yet it generated more international attention than almost anything else in the package. The reaction reflected a growing anxiety across north-western Europe, where prolonged workplace absence has become a serious drag on economic competitiveness.
Just how bad is Europe's sick leave problem?
The numbers paint a stark picture. According to the Organisation for Economic Cooperation and Development, the average French worker takes 4.1 weeks of sick leave per year, while German workers take 3.5 weeks. Belgium sits at 3.9 weeks, Finland at 4.8, and Norway tops the table at 5.7 weeks per worker annually. Portugal, Spain, Slovenia and Sweden also rank among the highest in the world.
Germany has carried the informal label of "the sick man of Europe" for decades, and the tag has rarely felt more fitting. Its industrial base faces intensifying competition from China, its population is ageing rapidly, and its hard-won reputation for efficiency is under strain. Merz framed the sick-leave crackdown in blunt terms: "We can no longer afford the competitive disadvantage caused by prolonged absences from work."
By contrast, British workers took just 4.4 days of sick leave per worker last year, according to official statistics — though the UK faces a different challenge, with a significant share of working-age people having left the workforce altogether due to long-term illness. American workers recorded similarly low absence figures.
Norway takes a different approach with 'graded sick leave'
Norway, which carries the heaviest burden, introduced a new policy in April centred on the concept of "graded sick leave". Rather than a doctor's certificate automatically signing an employee off work entirely, physicians will now be required to advise employers on how much work an unwell employee can reasonably perform. Where a doctor determines a patient cannot work at all, a specific justification must be provided.
The financial incentives built into the system are striking: doctors who prescribe less time off will receive higher consultation fees, while those who sign patients off entirely for non-specific reasons will earn less. The Norwegian government currently spends an estimated 67 billion kroner — roughly $9.8 billion — per year subsidising employer sick-leave costs.
Norway's Health Minister Jan Christian Vestre, a member of the Labour Party, posed a pointed question when announcing the changes: "We have to ask ourselves whether it has become too easy to go to the GP and ask for a sick leave."
Pushback from unions and within coalition governments
Neither Merz nor Vestre has had an easy ride with their proposals. In Norway, trade union leader John Magne Pedersen Tangen argued the new policy unfairly placed blame on workers rather than tackling what he described as a "broken GP service" and poor workplace arrangements by employers.
In Germany, the resistance came from within Merz's own coalition. His labour minister, Bärbel Bas of the centre-left Social Democratic Party, publicly distanced herself from the sick-note measure, telling local media: "That wasn't my proposal." Medical associations also warned the policy would overwhelm already stretched general practices with patients seeking certificates for minor ailments, arguing those workers would be better served by simply staying home to recover.
Notably, Merz's day-one doctor's certificate requirement is not without precedent — the same rule already exists in Belgium, suggesting the policy is more about political signalling and economic urgency than radical innovation. What is clear is that across much of Europe, the era of unchecked workplace absence is coming under serious political scrutiny.
