The Arizona Government's 'Easter Agreement' cracks down on long-term sick workers in the name of boosting economic activity. Political opposition is up in arms, as are doctors who fear mass stigmatisation of chronic illnesses.
The Easter Agreement is the Arizona coalition's first major legislative package since it entered government in February. The coalition wants to raise employment to 80% by 2030 (it was 72.8% in 2024) and has targeted unemployment benefits and long-term sick leave to do so.
To prevent fraudulent use of long-term sick leave, the rate at which doctors administer sick notes will come under heavier scrutiny. Medical professionals who wrongfully grant sick leave will be fined. The details of this procedure remain unclear.
Credit: Belga
From 1 July, paper certificates will disappear. All doctor's notes will be collected on an online database by the end of 2025.
Employers will be able to report doctors they suspect of prescribing fraudulent sick leave to a "hotline".
Employers will also be required to contribute 30% of the sickness benefit of an incapacitated employee during the second and third months after the first four weeks of guaranteed income.
'We want to help people'
Roughly 500,000 people are on long-term sick leave in Belgium – 1.5 times more than the number of unemployed people.
In this context, Employment and Economy Minister David Clarinval (MR) has hailed a "historic" reform. "It represents a decisive step forward in terms of employment, job activation, as well as in terms of economic recovery and the country's competitiveness," he stated.
Public Health Minister Frank Vandenbroucke (Vooruit). Credit: Belga / Kristof Van Accom
Frank Vandenbroucke of Vooruit – the coalition's only left-leaning partner – is Health Minister. "Long-term ill patients receive the right guidance and opportunities to return to work on a tailored basis, through a stronger return-to-work plan," he said of the reforms on social media.
The revised plan consists in withholding benefits for sick people who fail to show up to two medical appointments. There will be a 10% cut if they do not meet with a return-to-work coordinator. Doctors will now be able to list activities an employee is capable of carrying out.
In addition, "employers should focus more on prevention, which is always better than a cure," says Vandenbroucke. "We want to help people who are still on the sidelines to take the step back to work."
'A breach in solidarity'
Within the medical profession, doctors have expressed concern at a "hunt" for fraudulent behaviour, taking away from a doctor's caregiving responsibility.
"This is an attempt to stigmatise people who are unable to work," President of the Belgian Association of General Practitioners (GBO) Lawrence Cuvelier told The Brussels Times.
A healthy person wrongfully using long-term sick leave is an exceptional practice, and exceptions are difficult to legislate on, Cuvelier explains. The majority of people on leave "have either musculoskeletal disorders problems or something similar, and one-third have mental health issues or 'burnout'".
Credit: Canva
The doctor says the reform attempts to "blame either the patient or the doctor, when in fact every situation is extremely complex. This is a breach in Belgium's strong system of solidarity."
The Belgian Association of Medical Unions (ABSyM) echoes fears of "blame transfer". "Sanctioning doctors seems excessive to us," the organisation stated. "We fear that doctors who might prescribe 'too many' sick leave certificates compared to the average will no longer treat certain patients for fear of being sanctioned."
Opposition parties have attacked the Easter Agreement, which "confirms the austerity trajectory" (Ecolo), continues to push people into "working more to earn less" (Socialist Party) and is a "one-shot without vision" (DéFI).
The radical left-wing Belgian Workers' Party (PTB/PVDA) has called on the public to join a national demonstration against the "anti-social" agreement in Brussels on 27 April.
