The Employment Appeal Tribunal (EAT), in the claim of Croft Vets Ltd and others v Butcher, considered whether a veterinary practice - by failing to pay for a depressed employee's private psychiatric treatment - had breached its duty to make reasonable adjustments to enable her to return to work.

The claimant had worked for a number of years as a finance and reception manager at the practice. From 2008 to 2010, due to a combination of additional duties and the serious illness of her mother, the claimant came under severe pressure and her performance began to suffer. In March 2010 she was relieved of several of her duties and told to concentrate on just one. However, in April 2010, after she was found in tears, the claimant was offered two choices by her employer: (i) continue with her current role and take steps to improve her performance; or (ii) narrow her job description and take a pay cut. The following week, the claimant was signed off sick with depression.

The claimant's GP recorded that she had had work-related stress for two years and diagnosed "classical depression". The employer referred the claimant to a private consultant psychiatrist to prepare a report on her condition. The report, produced in August 2010, confirmed that the claimant had suffered from work-related stress that triggered a severe depressive episode, and recommended that the employer fund a course of cognitive behavioural therapy ("CBT") as well as further psychiatric sessions. However, the doctor also stated that there was no guarantee that the claimant's health would improve to the extent that she would be able to return to work. The employer wrote to the psychiatrist to ask further questions about his report, but did not pay for continuing treatment.

In November 2010, the claimant resigned. In her resignation letter she said that her workload was intolerable and that it had caused her stress and depression, she had received no communication from her employer since its contact with the psychiatrist and that the employer had ignored his recommendations. The claimant succeeded in claims that the employer failed to make reasonable adjustments on account of her disability and that she had been constructively unfairly dismissed.

The EAT agreed. It found that the employer, by failing to pay for CBT and psychiatric sessions, had failed to make reasonable adjustments to allow her to return to work. Reasonable adjustments must be "job-related" and the EAT found that this specific form of support was job-related as the primary cause of the claimant's illness was workplace stress. The EAT accepted, however, that the issue in this case was not one of an employer having to pay for private medical treatment in general, but rather one of payment for a specific form of job-related support.

Practical consideration for employers

This case does not impose on an employer a general obligation to provide its employees with medical care. Here, the employee's depression was linked specifically to the stress she had suffered at work, and the adjustment required was the funding of specific job-related psychiatric treatment. However, this case does illustrate the need for employers to be aware of their duty to make reasonable adjustments for disabled employees, and moreover the various circumstances under which that duty arises. The duty is not limited to the perhaps more common instances of making alterations to business premises or to a disabled employee's workspace; it applies in a much wider category of cases. This case should also prompt employers to consider generally how they approach the issue of the mental health of their employees.