The clouds of economic doom have gathered. When a sober chancellor tells you it is the worst situation for 60 years, it is time to take notice.

The hubris of the decade from 1997 to 2007 seems a distant dream. We know now that bust is back and we must hope for recovery - if not boom - to follow.

It is a good time for those who work in the public sector to think about three things.

First, the relative security we enjoy. There may be redundancies as a result of recovery plans or service change. But no one is going to turn up for work at a trust or primary care trust to find the doors locked, with a notice saying the organisation has gone into administration and P45s and wages owed (if you are lucky) can be collected. We are protected from these harsh realities and should be grateful.

Also, NHS pensioners can reasonably assume the pension fund is not going to disappear, and I am certainly grateful for that. Indeed I suspect that friends who went into the private sector and mocked my miserly potential "40/80ths", may now take a different view of an inflation-proofed final salary scheme. So despite all the frustrations of life in the public sector, we have much to be grateful for.

The second thing to bear in mind is that not all our colleagues are protected to the same extent. Those whose partners work in the private sector - and in particular where partners are the main source of income - may well experience the extreme pressures now being felt by those facing repossession of their homes and/or a complete reassessment of their lifestyle and life chances.

There is a challenge here for line managers to understand the stress this may cause and not to assume staff are immune from the gathering storm.

The third thing is the effect on the health of the population. It is reasonable to assume GPs and their teams will be seeing more people with anxiety and depression. The loss of your home and your dreams and the prospect of life in bed and breakfast accommodation is enough to destabilise the most robust personality.

Mental health services may well be affected as clients face financial and social challenges that threaten hard-won recovery. Acute services will also feel the impact.

I know from personal experience just how powerful the connection is between the mind and the body. In my last years at work, when I was under extreme stress, I submitted myself to unpleasant examinations. I found that there was nothing physically wrong and realised my symptoms were a product of my distress. Diagnostic departments may well be asked to examine patients whose real problem is the terror of homelessness and lost dreams.

We need to remember the fragility of most people's economic circumstances. You see a family with a lovely home, a company car on the drive and all the advantages of comfort and security. All that may well be based on one job - and the lifestyle goes when the job goes. Suddenly there is no car on the drive - and pretty soon no drive and no home. It is tough out there.