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Thomas Telford, the 18th century civil engineer who transformed Britain's transport infrastructure, was a stickler for health, safety and welfare. Absenteeism was nonetheless a constant bugbear. Away from home and family for months on end, his workers fell prey to stress and loneliness, reported sick and temporarily decamped.

Railway engineers George and Robert Stephenson experienced similar problems and, like Telford, noted that weekly paydays led to binge-drinking, hangovers, an unfit workforce and lost production. Their attempts to impose monthly pay met huge resistance.

Telford, perhaps better than the Stephensons, understood that people only give of their best when employers meet them at least half way. Knowing that his own prosperity and progress depended entirely on his workers, he respected them. Sadly, that basic law of personnel relations is these days often ignored.

The modern world of work is in thrall to market forces, those capricious but mighty creations which might not actually exist outside the collective imagination. Personnel are no longer quite human but objectified "resources", almost like bolts of fabric or lengths of timber. There is little long-term security for any worker and the inherent weakness in their position allows employers to reign with quiet terror and work them into the ground. Work and competition always go hand in hand but the contest now is not for promotion or recognition but to stay on the right side of the gulf between wage and dole.

While local authority staff are partially divorced from this cut-throat environment, the targets, star-ratings and other pointless activities foisted on the public sector play their own part in undermining staff well-being. In social services, chronic understaffing and unsympathetic management are seen to add to the ills. They are only part of the problem.

Where workers lack control over outcomes, their physical and psychological health may degenerate. In social work, that sense of control hinges on the client's fate, which, given the infinite number of possibilities, is outside anyone's authority. It is a lonely, often thankless job, bearing enormous responsibility and dogged by the constant fear of failure. Most social workers understand the nature of their task, so what is it that tips so many over the edge?

Private sector employee benefits rarely compare with public sector. For example, private sector workers receive only statutory sick pay, whereas council staff with sufficient service are eligible for six months' full pay and six months' half-pay. In the face of financial disincentives, staff may baulk at taking sick leave, irrespective of stress, misery and job dissatisfaction. But this is not an argument for abolishing sick pay. The skills required in the private sector are often more easily deployed. The unhappy worker can move, but where else can social workers employ their particular talents?

The Victorian work ethic remains powerful and the unemployed attract contempt rather than compassion. Similarly, sympathy for sickness absentees rapidly evaporates, for their absence increases the burden of work and stress on colleagues already struggling to manage their own workload. Resentment builds, alongside the likelihood of others collapsing under the extra strain.

The absentee knows they will be missed but the longer they stay away, the smaller their expectation of being welcomed back with open arms. On return, work will be a less forgiving place, and that knowledge heaps fear and guilt onto the mountain of tensions which first induced illness.

Sickness absence demolishes any control that staff may have over an activity crucial to their own and their family's welfare. Changes in the workplace, over which they are powerless, will inevitably occur and they may go back to strange and even hostile territory. Moreover, unless management is genuinely open and engaged with the workforce, absentees have no way of knowing how illness might affect their future. Will they be marginalised or forced into retirement? The fear generated by such uncertainties can lead to a spiralling health decline which kills off any real recovery.

Social workers need optimum working conditions to do the best for clients. While Unison is right to call attention to staffing levels and recruitment, this particular malady will be better cured by radical changes in management structures and attitudes.

Alison Taylor is a novelist, a former senior child care worker and the winner of the 1996 Community Care Readers' Award.