Sickness, Discourse, and Workplace Discipline: A Critical Perspective

The statement that "illness costs the employer money" is often delivered in the workplace as a neutral, factual observation. Yet its delivery and reception are far from neutral. Rather than functioning purely as a descriptive utterance, it operates within a web of social relations, institutional hierarchies, and communicative expectations. This essay argues that such statements have ideological and pragmatic force: they shape worker behaviour, promote presenteeism, and obscure the structural conditions that generate illness and absence. Drawing on both empirical data and theoretical insights — notably from Jürgen Habermas and Karl Bühler — we can begin to understand how these seemingly factual statements act as disciplinary mechanisms.

Jürgen Habermas critiques the truth-conditional model of semantics — the idea that language merely corresponds to objective facts — as a “descriptive fallacy.” Language, he insists, always emerges within a social context and performs multiple functions: not only conveying information (truth), but also expressing intentions (sincerity), appealing to norms (rightness), and demanding mutual understanding (comprehensibility). In the workplace, managerial statements about sickness rarely serve a purely descriptive function. Instead, they serve to normalize particular behaviors, reinforce power hierarchies, and individualize responsibility for systemic issues.

The claim that “illness costs money” does more than describe an economic reality; it frames the employee as a cost-burden and implicitly encourages self-discipline — or more plainly, coming in sick. Within Habermas’s framework, this is strategic communication disguised as communicative action. It is not aimed at mutual understanding but at behavioural modification under the guise of truth.

Karl Bühler’s organon model supports this critique by recognising that language has three functions: representational (informing), expressive (revealing the speaker’s attitude), and appellative (influencing the listener). A statement like “illness costs us money” appears representational but is deeply appellative. It encourages guilt, implies non-compliance is irresponsible, and enjoins the worker to return regardless of their health. This is especially problematic when such statements are issued within power-laden contexts — where refusal may carry formal or informal consequences.

This ideological and pragmatic function of language is substantiated by multiple studies on presenteeism and sickness-related workplace policy: A UNISON Scotland survey found that 48% of public sector workers felt pressured by absence policies to attend work while unwell. MHR’s research reported that 71% of UK employees have worked while unwell to avoid being perceived negatively, and 74% feared it would hinder career progression. A Minster Law survey revealed that 42% of UK workers feared losing their jobs if they took sick leave — with 64% willing to forgo basic employment rights for job security. In HMRC, nearly half of employees said they avoided taking sick leave due to fear of disciplinary procedures.

The Institute for Public Policy Research (IPPR) found that presenteeism caused UK businesses to lose £100bn in productivity annually, with an average of 44 days lost per employee — a paradoxical outcome of trying to reduce sick leave.

These statistics show that discourse around sickness is far from neutral. It becomes a vector for disciplinary power — modifying behaviour, inducing fear, and undermining both health and productivity. In such an environment, even supportive tools like health passports or wellbeing monitoring become tainted if they are introduced within a punitive cultural framework.

Recognising the ideological weight of managerial discourse is a necessary step toward fostering a healthier, more democratic workplace culture. While employers may appeal to “facts,” the context in which these are communicated — and the social pressures that shape interpretation — matter enormously. As Habermas and Bühler remind us, language is never just about facts; it is always about relations, norms, and power.

To move forward, organizations must challenge the idea that sickness is an individual failing or a financial inconvenience. Instead, they should embed communicative practices that affirm health as a collective good, and sick leave as a right — not a burden.