#The Big Idea: Give all Canadian workers paid sick leave

Canadians are working while ill to avoid losing income. Instituting country-wide sick-leave policies is a healthier option.

For the past 16 years, I’ve worked as a family doctor in community clinics throughout the country—in Yellowknife, La Ronge, Saskatchewan, Toronto, and in Sydney, Nova Scotia, where I’m based right now. In all of these clinics, I’ve encountered patients facing the same crippling dilemma: work while ill or lose income because their employer doesn’t provide them with paid sick days. As a doctor, my typical advice is for them to stay home and take all the time they need to recover. Many aren’t able to, and some end up back in my office a week later with a more severe version of their initial illness. I don’t blame them: we live in a country where paid sick leave is seen as a privilege, rather than a universal right.

One of my current patients is a single mom of two young kids who works two part-time jobs in health care, neither of which offer her paid sick leave. Because she has difficulty covering basic expenses, she will sometimes go to work when sick—even though she works with vulnerable patients, many of whom are at risk for severe illnesses if she infects them. She confided that, sometimes, she also sends her sick kids to school if child care isn’t an option.

After many years of witnessing scenarios like hers, in 2018, I joined the Decent Work and Health Network, or DWHN, an advocacy group of health-care workers focused on creating equitable conditions for all workers, including migrant workers. Factoring in the recovery times for common minor illnesses, worker experiences and evidence from other countries, DWHN is pushing for a minimum of 10 employer-provided, provincially mandated paid sick days per year for everyone in Canada. Medically, 10 days is a reasonable ask: barring serious health issues, people usually catch a cold once or twice a year, and other illnesses and injuries, like twisted ankles, happen occasionally.

Widely available paid sick leave can save lives. During the COVID-19 pandemic, I worked as a Medical Officer of Health in Newfoundland and Labrador, and public health advice across the country was for sick people to stay at home to protect their coworkers and neighbours. Many didn’t, which contributed to outbreaks in schools and workplaces. Elsewhere, in Ontario, approximately 66 per cent of COVID-19 outbreaks in the Peel Region were traced to workplace transmissions.

The pandemic may have been an unusual event, but it highlighted employment inequities that have existed for a long time. Early data from Ontario’s Peel Region showed that low-income individuals were the most likely to continue working while infected with the COVID-19 virus. Then, in 2023, Statistics Canada released a report that showed that racialized Canadians are typically less likely to have paid sick leave than white Canadians. (Nearly 65 per cent of white women have paid sick leave, compared to just over 54 per cent of Southeast Asian women and less than 60 per cent of Black women.) Many of my patients are from low-income and racialized backgrounds, so these disparities are an ongoing source of frustration for me. The same people who were praised as heroic—the front-line workers staffing our hospitals and grocery stores during the pandemic—were simultaneously denied employment protections that would have kept them safe. 

Working while ill isn’t just problematic in pandemic times, either. Outbreaks create a snowball effect within our already strapped health care system, leading to sicker patients, longer wait times at overcrowded ERs and acute-care bed shortages across the country. I’ve also seen many patients who are struggling with their mental health who could have used time off but couldn’t afford to stay home. In one recent example, one of my patient’s homes burned down in a fire. I could tell she was reeling from the loss, but she felt compelled to put in hours anyway. Without adequate leave, mental health issues compound, which leads to more people in crisis.

Many unionized workers and people in higher-paying jobs have contracts that guarantee set numbers of paid sick days. For everyone else, coverage is scattershot. Roughly half of Canadian workers don’t have sick days—including gig workers (like Uber drivers), personal support workers (for example, in hospitals and nursing homes) and many employees in the hospitality and retail sectors. Currently, B.C., P.E.I., and Quebec are the only provinces that mandate paid sick leave. (B.C. leads the way with five, while Quebec offers two. P.E.I. provides one to three days based on employment duration.) As part of an effort to stem the spread of COVID, Ontario allotted its workers three paid sick days beginning in April of 2021 but terminated the program two years later. The federal government began offering 10 paid sick days per year for federally regulated employees in 2022, which is a good start. Unfortunately, federal employees only constitute about six per cent of the country’s workers.

In the past, governments have justified a lack of sick leave provisions by citing the financial strain it places on businesses. Indeed, many workplaces have consistently opposed paid sick leave for that same reason, arguing that they can’t afford to pay employees who are not working. However, paid sick leave policies offer many benefits to businesses: plenty of research has demonstrated the positive physical and mental health outcomes that come from giving workers recovery time—for one, healthier, more productive employees who are less likely to spread infections. Without paid sick leave, some of my patients have told me that they feel that their employers view them as disposable. When employees feel supported, however, they typically end up staying at their companies longer.

Hesitant businesses might worry that their employees will take advantage of all their paid sick days, whether they’re sick or not, but research doesn’t bear that out. Paid sick leave is already the norm in many other places, including 14 U.S. states and European countries such as Ireland. In jurisdictions with paid sick leave, seven to 10 paid sick days a year is the norm; people tend to use roughly three to five. They take only the time they need, then get back to business.

Making paid sick leave a nationwide reality in Canada isn’t going to come as a result of federal legislation. Here, labour standards are left up to the provinces and territories, so the onus is on them. When B.C. mandated its five paid sick days, it was the result of years of concerted campaigning from organizations like the Worker Solidarity Network, the B.C. Federation of Labour (a union that represents half a million workers across the province) and former B.C. premier John Horgan. Unionized workers can lobby their employers for 10 paid sick days in their collective agreements. Both unionized and non-unionized workers can make paid sick days a political priority by creating widespread public pressure, whether or not elections are happening. They can also support the efforts of advocacy groups like Justice for Workers and DWHN. There is power in a collective voice.

As people across Canada struggle to cope with soaring costs of living, I worry that they’ll be forced to make bigger and bigger compromises with their health to manage their precarious financial situations. Until paid sick days are the norm, they don’t have much of a choice. In addition to COVID-19, there are still many potentially serious infections out there, like flu and strep. Paid sick day legislation is a way for our governments to guarantee basic labour standards that support health, for workers, their families—for all of us.

—As told to Ali Amad