Doctors say a large number of sick-note requests are fake

Norwich Union Healthcare's Health of the Nation Index survey questioned over 250 doctors and 1,000 members of the general public.

It found around three million workers would consider asking for a fake sick-note, with men being the main culprits.

Around 22 million sick notes are requested in the UK each year - an average of 577 for each GP.

Doctors questioned said around one quarter of sick note requests were questionable, while a fifth were completely invalid.

The survey also revealed the most frequent causes for sick notes to be back pain, depression, stress and the flu.

Trouble saying no

Among the reasons workers said they would give to get a sick note were a personal crisis they couldn't tell their employer about, work-related stress, not wanting to use their holiday entitlement, and fatigue.

Previous GP surveys have highlighted debate over sick notes, with some doctors admitting to issuing them too readily, and many saying they don't want to have to issue them at all.

Dr Ann Robinson, who took part in the Norwich Union survey, said: "GPs want to treat genuinely ill patients and don't want to act as policemen, identifying those who are claiming bogus sick-notes."

People seem to think the GP's job is to back them willy nilly. In the old days people wouldn't ask the GP to do it, now they'll complain that you failed to provide a service. Dr Peter Holden

Dr Peter Holden, a senior member of the British Medical Association's GP Committee and GP in Matlock, Derbyshire, said he refuses to issue a sick-note if he doesn't believe the patient is really sick.

"I tell patients I'm not prepared to perjure myself," he told BBC News Online.

"When you issue a sick-note you should only certify the truth.

"Doctors are always being asked to sanitise the dubious.

"People seem to think the GP's job is to back them willy nilly. In the old days people wouldn't ask the GP to do it, now they'll complain that you failed to provide a service.

However he said some doctors do have trouble saying no.

"Doctors always want to be loved."

More than a fifth of the 255 GPs interviewed for the research said up to 20% of their patients were unable to work because of health reasons.

But the survey also found 40% of GPs believe at least one third of patients off sick could actually do a few hours a day, but employers aren't encouraging them to return to work.

Dr Robinson said: "Employers need to be more flexible with their workforce and hospital services need to provide fast track diagnostic and treatment centre so that people can get back to work as quickly as possible."

The index also revealed Scotland has twice as many requests for sick-notes as the rest of Britain, while East Anglia has the lowest rate of requests.

It also found almost half of doctors spend one third of their time on social rather than medical issues.