The economic crisis and resulting restructurings, downsizings, financial worries and fears of dismissal due to absence from work are significantly influencing employees’ decisions on whether to continue working despite ill health. Studies suggest that the economic costs of presenteeism (working while sick) far outweigh the costs of absence from work on the grounds of sickness. The level of sick pay regulation as well as weak protection against dismissal and a lack of privacy of health data are important drivers for the increase in presenteeism. Activation policies focusing on the sick or long-term sick may give rise to some significant risks for basic human labour rights such as the right to work, just and favourable working conditions, and the fundamental right to social security including paid sick leave and the right to privacy. As a result, a human-rights based approach to human resource management is needed. This is not just in the interest of employees, but is also the better option from a public health perspective.

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The world of labour is in transformation due to automation, digitalisation and platform work. Digitalisation is changing the classic relationship between employer and employee; this also affects workers’ participation rights within the company. New forms of work demand very high self-organisation and active commitment on the part of employees to solving process problems and optimising processes. If at the same time management and organisational structures remain largely top-down and employees hardly have any say, this is contradictory. Co-determination is a central component of qualified work. Without the expansion of democratic processes within the company, the opportunities offered by digitalisation will not be fully exploited. Digital processes require cooperation across technical, departmental, and hierarchical boundaries, which must inevitably lead to the democratisation of company decisions. Digitalisation may also act as a catalyst for the dormant debate about “democracy in the workplace”.

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