If the flying's that bad on the 787 (or 777-x) sick leave will go up accordingly. With no ADP there will be no incentive to go work if crew feel like they need a break, unlike now. If crew are starting to feel fatigued, I reckon they will be far more willing to fix it by judicious use of personal leave. What doctor won't provide a sick certificate for several days if a pilot says they're overtired? It's up to the individual to determine if they're fit to fly and the new contract provides little incentive, other than allowances, to actually go to work.