Ours is a very demanding job. Teachers learn very early on that a night on the town will be followed by a truly awful day at school. The classroom is no place for a hangover. But what about real illness: stress, depression, long-term physical injury, deafness, sight problems, or even cancer? What happens to teachers who fall victim to any of these?

There is an ill-health retirement scheme. Throughout the 1980s and 1990s, thousands of teachers left the profession early, with the benefit of a full pension. But the rules changed in 1997. One local authority expert joked grimly to The TES that ill-health retirement for teachers is now awarded “posthumously”.

This isn’t entirely accurate. The reality, as the same person admitted, is that in the 1970s and 1980s, local authorities used early retirement as a way of easing teachers out of the job. This was at no cost to themselves because the Government funded the programme, hence the rule change in 1997.

The figures (see box) reveal the effect the changes had on the numbers going through the scheme. There has been a 60 per cent reduction in those accepted: from 6,075 in 1994 to 2,272 last year.

The 1997 change said no more early retirement unless medical incapacity was likely to be permanent, that is, lasting until teachers’ normal retirement age. In 1997, that was 60. But new proposals for entrants and those under 50 mean that the retirement age will soon be 65.

The problem is for those suffering from some debilitating and long-term conditions. People with myalgic encephalomyelitis, better known as ME, suffer from drastically reduced levels of energy. Most doctors accept that it would be difficult or impossible for them to cope with a high workload job such as teaching. Yet the long-term prognosis for ME is good: most patients do recover, even though it may take anything up to six years for them to return to full health. As things stand, people with such conditions can expect no early-retirement package unless they are already close to retirement. The same applies to patients with treatable cancers and virtually all those who fall victim to stress or depression.

Teachers are entitled to six months’ paid absence for sickness, followed by a further six months on half pay. This means that long-term illness is frighteningly expensive for employers. People with no hope of an early recovery may find themselves out of a job.

In Birmingham, the trigger date for the local authority getting involved is four to six weeks after an absence begins. It’s then that the authority contacts a school and suggests a referral to the LEA’s occupational health service. This is a medical service with specialist doctors and nurses. OHS staff may be paid by the employer, but they are subject to the same rules of confidentiality as other medical professionals. Their job is to assess an individual’s fitness for work and to help people who have been ill make a “managed return” to the job.

In most working environments this is relatively simple. An employee might return on reduced hours, or to a less stressful role, building up to full normal working over time. It is this “managed return” that is so difficult for teachers.

“We had someone off with stress,” says one headteacher. “They were off for a whole term, and when they came back, it was on a reduced timetable. But the everyday pupil contact was still there, along with the stress in lessons. It’s very difficult to ease someone back into teaching.”

This situation was complicated by the school’s cover insurance, which paid for a replacement teacher as long as someone was not in school, but didn’t pay for the kind of flexible cover needed for a managed return to work.

“It cost us a fortune and in the end we had to let the teacher go,” says this head.

In a big authority like Birmingham, things can be easier to manage.

Sometimes a teacher can be found a different role in another part of the authority. “It’s down to co-operation and consultation with all parties,” says a Birmingham spokeswoman. “We do try to place people in other schools.”

Local authorities have to tread carefully. Maintained schools can be encouraged to offer places to teachers who want a move, but foundation schools can ignore the blandishments of their local authority - and some do. Which is a shame, because an excellent teacher does not cease being good at their job simply because they have been ill or have a disabling condition.

There are success stories. Occupational health service support can be a real boon for teachers with a physical disability. Experts can assess a classroom to suggest technological aids that will make life easier for someone with a problem.

In one case they negotiated with a school to move a teacher in a wheelchair to a ground-floor classroom; in other cases, classroom assistants can be provided to help a disabled teacher continue working. Under disability legislation, consideration of this kind of adaptation to the working environment is now a requirement. Funding to cover some of the cost is available from the Government’s Access to Work scheme. In Birmingham this is managed centrally and allows dozens of teachers to continue working.

In the worst-case scenarios, teachers are still awarded ill-health early retirement. “Once we know that someone is terminally ill, then everyone pulls out the stops,” said the Birmingham spokeswoman.

Other teachers have been accepted onto the scheme after disabling car accidents or following diagnosis of debilitating illnesses such as heart disease or multiple sclerosis. The long-term nature of the illness has to be confirmed by a specialist, but, once it is, the good news is that a teacher’s exit from the job is likely to be made less complicated by new paperwork procedures introduced this year.

The bad news is that the Government is proposing to amend the rules to cut ill-health retirement benefits for those individuals who may not be fit to teach, but could do another, less demanding job.

It seems that for some teachers serious illness may only be the start of their problems.

Details of the Government’s ill-health retirement scheme can be found at: www.teachernet.gov.ukmanagementatozrretirementongroundsofillhealthInfor mation about Access to Work is available from local authorities and from Job Centres