NHS Nurse Wins Dismissal Case Over Right to Wear Necklace with a Cross

Peter Russell

January 11, 2022

Editor's note: This story was updated with a comment from the Croydon Health Services NHS Trust

A nurse who refused on religious grounds to remove her necklace with a cross while on duty was discriminated against by her employer, a tribunal ruled.

Croyden Health Services NHS Trust was found to have directly discriminated against and harassed Mary Onuoha after she refused to remove the cross necklace in 2018 because it was a symbol of her Christian faith.

The London South Employment Tribunal held that while the Trust claimed health and safety issues were behind their demand, Ms Onuoha's rights had been breached, as wearing jewellery was "rife" among doctors and other nurses and was widely tolerated by management.

There was also "no cogent explanation" as to why other items of religious apparel, such as headscarves, turbans, and kalava bracelets, that carried a broadly comparable risk factor, were permitted, "but a fine necklace with a small pendant of religious devotional significance is not", the tribunal said in its ruling.

However, it rejected a suggestion that in requiring the claimant to remove her necklace, the Trust had deliberately targeted the cross as a symbol of the Christian faith, or that it had acted out of any kind of prejudice towards Christianity.

Ms Onuoha had been employed by the Trust since 2001, including as a theatre practitioner, during which time she had worn a necklace with a cross both in and out of work.

For the first 13 or 14 years nobody challenged her about it, but between 2014 and 2016 she was asked on three occasions not to wear it while on duty. However, she declined to remove it on religious grounds, and the issue was not followed up.

CQC Inspection Criticised Dress Code Violations

Matters came to a head when Croydon Health Services was criticised in a Care Quality Commission inspection for failing to enforce Department of Health dress code and uniform policy, which prohibited wearing necklaces in clinical areas.

During a campaign by management to enforce the code, Ms Onuoha again refused to remove the necklace on religious grounds, a request to the nurse that the tribunal agreed was "humiliating and offensive".

Croydon Health Services NHS Trust had a code that accepted cultural and religious apparel "as part of welcoming diversity", the tribunal heard.

The nurse's lawyers argued that the dress code was applied inconsistently, with other nurses and members of staff frequently wearing various types of jewellery, including religious bracelets, in wards and in theatre without being asked to remove them.

'Hostile and Intimidating'

Ms Onuoha reported being confronted by a senior Trust manager in 2018 about the cross necklace while she was helping to care for a patient under general anaesthetic in the operating theatre, in what the tribunal said gave the claimant the sense she was working in "a hostile and intimidating environment".

The dispute escalated into disciplinary and grievance procedures, and Ms Onuoha was redeployed to non-clinical duties.

She was given a final warning and her grievance was rejected. She resigned, claiming constructive dismissal, when the Trust indicated that it would start a second set of disciplinary proceedings against her.

In its summary on 5 January, the tribunal said of the Trust management: "No real thought seems to have been given to whether it was really appropriate to discipline the claimant for doing something that in fact many others in the workforce (including more senior colleagues who worked just as closely with patients) were doing unchallenged.

"Equally, no real thought was given to the claimant’s point that others were wearing religious apparel in clinical areas, and that she should be treated equally to them."

Furthermore: "Applying common sense, it is clear to us that the infection risk posed by a necklace of the sorts the claimant used to wear, when worn by a responsible clinician such as the claimant, who complied with handwashing protocol, was very low."

The Tribunal also found that the Trust constructively dismissed Ms Onuoha "without reasonable and proper cause", and that the dismissal was unfair and discriminatory. A spokesperson for Croydon Health Services NHS Trust told Medscape News UK : "We would like to apologise to Mrs Onuoha and thank the Employment Tribunal panel for their careful consideration of this matter. 

"It is important that NHS staff feel able to express their beliefs, and that our policies are applied in a consistent, compassionate and inclusive way.

"Since this matter in 2019, our dress code and uniform policy has been updated with the support of the Trust’s staff networks and trade union representatives to ensure it is inclusive and sensitive to all religious and cultural needs, while maintaining effective infection prevention and control measures and protecting the safety of our patients and staff. However, we will carry out a further review of our policy and practices in light of this judgment."

Andrea Williams, chief executive of the Christian Legal Centre, commented: " From the beginning, this case has been about the high-handed attack from the NHS bureaucracy on the right of a devoted and industrious nurse to wear a cross – the worldwide, recognised and cherished symbol of the Christian faith. It is very uplifting to see the Tribunal acknowledge this truth.

"It was astonishing that an experienced nurse, during a pandemic, was forced to choose between her faith and the profession she loves."


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