The closure of the Rover plant at Longbridge will cause widespread health problems, but the NHS could rev things up. James Garnett reports

The furious row over car firm BMW's decision to sell off its Rover plant in Longbridge, south Birmingham, has focused on the economic impact. But there is another dimension.

Local health professionals have grave concerns about what the events at Rover could mean for the region's health and well-being. Birmingham health authority director of public health Dr Jacky Chambers describes it as 'a potential disaster'.

BMW's move is expected to threaten around 5,000 jobs directly, while up to another 45,000 in associated industries around the West Midlands will be indirectly affected.

Dr Peter Borg-Bartolo, chair of Northfield primary care group, which has half the Rover workforce on its lists, was 'absolutely horrified' at the news. He says several patients have already been to see him suffering from Rover-related stress.

'There's been absolute uproar among many of the patients and the reaction has been very severe locally.'

Birmingham itself already has a whole host of public health challenges. Dr Chambers says: 'The unfortunate thing about the Longbridge decision is that Birmingham was just beginning to recover economically and to see improvements in the indices for perinatal mortality, teenage pregnancy and suic ides .'

Many of the plant's 8,000 shopfloor workers are 40-plus. Many may not have transferable skills.Dr Chambers says even those lucky enough to find work could end up in lower-paid jobs with poorer working conditions.

'The sense of job insecurity among such individuals can lead to worse cardiovascular health, increased risk of heart attacks and mental disorders.'

The need for health and social counselling services is likely to increase markedly.

Dr Borg-Bartolo estimates that up to an extra£3m will be needed to pay for more counsellors.

But Dr David Weddell, a singlehanded GP practising close to the factory, says: 'We're overspent on our drugs budget in our PCG. . . we're going to be even more overspent no matter what we try to do.'

Jean Trainor, chair of South Birmingham Mental Health trust, wants to see some of the£150m emergency support package announced by the government this week targeted at health.

Her bright idea, seconded by Dr Chambers, is to provide Rover workers with an escape route - into the NHS.

Rover and the NHS are the largest employers in Birmingham. Dr Chambers suggests Rover workers could find work in research and development, science and technical services, catering and portering.

Ms Trainor says: 'We ought to be able to think about how we can provide jobs for these people, not just look after them and their health.'

The trust's£2m Longbridge health and community centre, launched by the then public health minister Tessa Jowell in 1998, will play a pivotal role in the response.

To cap it all: Birmingham's health had begun to improve.

Home to Northfield PCG, it is a multidisciplinary centre providing dropin counselling services, along with social workers and a range of professions allied to medicine.

Ms Trainor says the trust will be getting the centre 'geared up and ready'.

Dr Borg-Bartolo wants action plans drawn up urgently. Good links with social services aren't enough: 'We need to be very sharp on the uptake with the other associated professions, district nurses and health visitors, as well as the voluntary sector.'

Meanwhile, a sense of anger is settling on Birmingham, as the government's Longbridge taskforce - comprising local government and business officials but not health or social services representatives - starts to hammer out a recovery plan.

And it's not just the workers who are angry. Dr Borg-Bartolo says: 'We are now left with a precipitous situation that is going to affect the health and social and psychological well-being of all our patients, and I feel really annoyed about that.'

Feeling the impact Dr Jacky Chambers, Birmingham's director of public health, says among the health repercussions of the Longbridge closure will be:

More self-referral to GPs for physical and non-specific symptoms.

Bed-wetting among children.

Higher demand for health and financial advice and counselling from health visitors, social workers and GPs.

Increased prescription of drugs for anxiety and depression.

Possible increased number of parasuicides (overdoses).

How the NHS can help Contribute to any regeneration taskforce as an employer.

Extra time, support and training for health professionals helping households where someone has been made redundant.

Provide therapy for those at high risk of depression and help families to get appropriate financial advice.

Put families in touch with other agencies such as social services.

Monitor the health impact resulting from the closure of Longbridge.