Judged against the touchstone of reasonable conduct, it is my judgement that the NHS trust was negligen

Judge Rex Tedd QC

The trust denied blame and said Mrs Witham chose to work extra hours without the help of colleagues.

The case went to trial at the High Court in London, resulting in Mrs Witham winning the compensation.

Giving his ruling, Judge Tedd detailed one period of eight days, in early 1996, just after Mrs Witham returned to work having given birth to her fourth daughter.

She had suffered severe post-natal depression following the birth.

Overtime build-up

On seven of those days, the judge said she had worked 10 hours and 14.5 hours on the eighth.

A standard working day was officially seven-and-a-half hours and, in little more than a month, Mrs Witham built up 148 hours of overtime.

Judge Tedd accepted she had only agreed to return to work on the understanding that she would be gradually eased back into her demanding role as a ward sister.

He ruled her employers, the Hastings and Rother NHS Trust, had "grossly dishonoured the arrangement that had been made to protect her health and welfare upon her return to work".

In the following year Mrs Witham was subjected to an ever-increasing workload and managerial responsibility, culminating in a mental breakdown in July 1997.

Covered for colleagues

She was working excessive hours, labouring under considerable stress with inadequate administrative assistance and covering for absent or sick colleagues.

Mrs Witham, who never went back to her job at the hospital after the breakdown, has since been retired on grounds of ill health.

Judge Tedd told the court: "I have concluded that the dominant cause of each of Mrs Witham's breakdowns was stress at work, brought on by the NHS trust's negligence.

"I reject the contention that Mrs Witham's working conditions were self-imposed or as a result of over-enthusiastic volunteering on her part.

Psychiatric injury

"Judged against the touchstone of reasonable conduct, it is my judgement that the NHS trust was negligent.

"During the period March to December 1996, the trust failed to allow the gradual return to work, or to provide the support, which it had promised Mrs Witham."

The NHS trust, he said, should have foreseen the "substantial risk" that Mrs Witham would suffer psychiatric injury.

Mrs Witham was described by the judge as a "hard-working, enthusiastic, efficient and caring" worker, who began the nursing career she loved at the age of 18.