Ferrie et al

This paper reports the findings of a longitudinal study of civil servants who were employed within a department that was ‘sold’ to the private sector in 1992. The study explores the extent to which these changes impacted on both the civil servants self reported health status and the use of GP services. The findings support those of similar studies in that job insecurity and unemployment was found to be associated with worse health and greater use of services.

The aims of the research are clearly set out and the overall design is appropriate to the question set. The authors clearly draw attention to the limitations of the study. The details contained in the final table (Table 4) could be more clearly presented and the authors may want to give some thought to this. The use of footnotes rather than labels is odd. A statement of why it was not possible to use other members (from other non-privatized Depts) of the Whitehall II study as a control could also be made. As things stand it is not clear why this was not done.

Overall this paper is very well written and provides important findings which add to the important debate on insecurity and health. It is especially important in the current context of the new ‘flexible’ work practices. Policy implications are usefully set out in the paper.

I recommend publication of this paper as it is certainly of interest to readers of the BMJ