MG v North Devon NHS Primary Care Trust

An employer owes an employee a duty to provide a reasonably safe system of work and to take reasonable steps against a foreseeable risk of psychiatric injury caused by workplace stress. Foreseeability is assessed by reference to the particular employee, including known vulnerability, previous stress-related illness, warnings, absences and other clear indications of impending harm. The employer is entitled to expect normal resilience, but must respond when those indications would be apparent to a reasonable employer. Breach requires failure to take reasonable steps in all the circumstances, including the employer’s size, resources and operational demands. Causation is established where the breach materially contributes to the psychiatric injury; liability may be apportioned where several causes contribute.

The claimant, a part-time health visitor, brought a personal injury claim against her employer for psychiatric injury allegedly caused by excessive workloads and failures to provide cover for absent colleagues. She had suffered a previous work-related depressive illness, returned under phased programmes, and later suffered relapses in June 2002 and February 2003. The defendant opposed amendments to plead the later relapse and argued that the Disability Discrimination Act 1995 and employment legislation displaced the High Court’s jurisdiction. The court also considered whether the claimant’s medical treatment, statements that she was coping, and alleged vulnerability affected foreseeability and causation.

1. Amendment and jurisdiction. The amendments were allowed. The claim was for damages for psychiatric injury caused by negligence, not a complaint of disability discrimination or failure to make reasonable adjustments. The Disability Discrimination Act 1995 did not exclude High Court jurisdiction. The reasoning in Johnson v Unisys and Eastwood v Magnox Electric did not govern a stress-at-work personal injury claim.
2. Duty and foreseeability. Liability for psychiatric injury from workplace stress follows the ordinary principles applicable to physical injury. The employer is liable where it ought reasonably to have foreseen the risk of breakdown and ought reasonably to have taken steps to avert it. Relevant matters included the claimant’s previous stress-related breakdown, her known vulnerability, warnings about workload, and the failure to replace absent colleagues.
3. Breach. The defendant breached its duty by failing to provide effective cover when colleagues were absent, failing to provide adequate support, and requiring the claimant to carry excessive caseloads contrary to an assurance that she would not do so. The claimant’s reports that she was coping did not remove the duty, because they had to be assessed alongside the defendant’s wider knowledge.
4. Causation. The breaches materially caused both the June 2002 and February 2003 psychiatric injuries. The misdiagnosis of chronic fatigue syndrome and failure to refer the claimant to a consultant were not negligent and did not break the chain of causation. The claimant’s vulnerability justified a 20 per cent reduction in damages.
5. The claim therefore succeeded on liability. Damages were assessed in principle, with counsel directed to resolve the remaining calculations and draft the appropriate order.

not stated in the judgment.