Reasonable Adjustments Can Embrace Private Medical Treatment

In a decision that may come as a surprise to employers, the Employment Appeal Tribunal (EAT) has ruled that an employer’s duty to make reasonable adjustments for over-stressed workers can extend to paying for private psychiatric treatment. Consequently, the former finance manager of a veterinary practice has won substantial compensation after her claim for constructive unfair dismissal succeeded (Croft Vets Limited and Others v Butcher).



Lynda Butcher had worked for Croft Vets Limited for 14 years, starting as a receptionist before working her way up to a position where she controlled its day-to-day finances. As the practice expanded, her workload increased to the point where she had difficulty coping and faced criticism of the standard of her work.



A combination of personal difficulties and work-related stress, which was aggravated by teething problems with newly installed computer and telephone systems, culminated in Mrs Butcher’s colleagues reporting that she had been seen staring out of the window in tears. She ultimately went on sickness leave and never returned to work.



Following her departure, Mrs Butcher’s GP reported that predominantly work-related stress had triggered a severe depressive episode and marked anxiety. He stated that she would require several months off work and recommended that her employer should fund private sessions of cognitive behavioural therapy (CBT).



The recommendation was not pursued by Croft Vets, however, and, following abortive attempts to arrange her return to work in a reduced role and a breakdown in communications, Mrs Butcher resigned. An Employment Tribunal (ET) subsequently found that she had been unfairly constructively dismissed.



In challenging that ruling before the EAT, Croft Vets argued that it had been entitled to seek Mrs Butcher’s return to work to perform the essential functions of her job. It was submitted that she had refused to engage with the practice following her departure and that it was under no obligation to pay for private CBT when such services were available free on the NHS but had not been taken up by her.



However, the EAT found that, in declining to follow the GP’s recommendation without any explanation, Croft Vets had failed to make a reasonable adjustment and breached the term of trust and confidence implicit in Mrs Butcher’s contract of employment. Noting that the issue was not the payment of private medical expenses in general, but rather payment for a specific form of support designed to enable Mrs Butcher to return to work, the EAT ruled that the ET had made no error of law.



Croft Vets did succeed in its appeal against a finding of disability discrimination made against it, on the basis that such a claim had not been placed before the ET. However, that made no difference to the practical outcome of the case and Croft Vets’ appeal was otherwise dismissed.