Andy,
perhaps it is now time for compulsory reporting of these medical issues where people are unfit for work
In the UK it is.
Licence holder not to act a member of flight crew when unfit
32B(1) A person is not entitled to act as a member of the flight crew of an aircraft registered
in the United Kingdom if he knows or suspects that his physical or mental condition
renders him temporarily or permanently unfit to perform such functions or to act in
such capacity.
(2) Every holder of a medical certificate issued under article 32 who-
(a) suffers any personal injury involving incapacity to undertake his functions as a
member of the flight crew;
(b) suffers any illness involving incapacity to undertake those functions throughout
a period of 21 days or more; or
(c) in the case of a woman, has reason to believe that she is pregnant,
must inform the CAA in writing of such injury, illness or pregnancy, as soon as
possible in the case of injury or pregnancy, and as soon as the period of 21 days has
expired in the case of illness.
Andy later clarified:
I meant compulsory for the medical staff certifying a person unfit for work to report it to the relevant authorities for certain critical professions.