Boris Johnson’s coronavirus diagnosis: what history teaches us about prime ministers and illness

Johnson has tested positive, along with several other key figures. EPA

It is routinely claimed that the present situation is unprecedented. Historians are deservedly secondary to epidemiologists as we try to understand how to manage the coronavirus pandemic, but though unable to provide inoculation, they can at least offer rectification. As overstated as it may at times have been in the UK, the second world war has justifiably become the standard comparator. It was, after all, the last time western nations suspended normal life.

In 1940, during the reign of George VI, Buckingham Palace was bombed, giving an unexampled symbol of the equality of sacrifice made during the conflict. The diagnosis of George VI’s grandson, Prince Charles, with COVID-19, and now the diagnoses of both the prime minister and the secretary of state for health – that is, the very people leading the government’s mobilisation against it – have further demonstrated the unpredictability of the current crisis. Boris Johnson’s last public act before finding out he had been infected was to join in the applause for those health and care workers on whom hitherto he depended only politically.

Ploughing on

For many nations, seeing a leader compromised in this way would trigger a much more immediate crisis than is evident in the UK at the moment. Johnson, however, insists he will continue his work as normal while self-isolating.

It was Johnson’s cherished prototype Winston Churchill who was the first, and so far the only, prime minister to have his own personal physician. A doctor was imposed on Churchill by colleagues who not only realised how much the prime minister was needed, but also how much the prime minister needed one. As it turned out, that physician’s experience contributed to the Churchill legend: of a man who could lead a country to victory despite manifold psychological and physical infirmities.

Churchill’s protégé, Anthony Eden, was altogether less robust – medically and, as was to be proven, reputationally. Eden’s fragile health is one explanation of why he thought invading Egypt in 1956 was a good idea. He ultimately resigned due to his illness. Andrew Bonar Law resigned in 1923 on receiving a terminal diagnosis, and Henry Campbell-Bannerman, prime minister from 1905 to 1908, actually died in 10 Downing Street.

Anthony Eden leaves Downing Street to tender his resignation to the Queen in 1957. PA

But the health of British prime ministers is more a matter of interest to the public rather than a matter of public interest – as in the case of US presidents. The differences between a presidential and a parliamentary system are highlighted at times of incapacitation.

US presidents see their medical records published and, when travelling, are accompanied by surgeons and supplies of their own blood type. The unseemly squabble between his secretary of state and vice president did little to stabilise the aftermath of the assassination attempt on Ronald Reagan in 1981. That vice president had his own public moment of incapacity a decade later. Infirmity is most damaging when it is also emblematic, as Jimmy Carter demonstrated live on TV, unable, not for the last time, to get past the finishing line.

Politicians are younger and fitter today, which is why there are so many fewer parliamentary by elections. There’s also total media scrutiny – that Churchill’s most serious stroke was kept secret was possible in 1953 in a way that would be inconceivable now. Revealing his diagnoses almost as soon as he knew about it, Johnson not only decided to self-isolate but to self-broadcast.

Second in command

There are, notwithstanding, constitutional implications. Our increasingly codified way of conducting public life in general and government in particular means that there’s a much clearer sense of process in many ways. But in the UK, much still rests on unofficial, essentially extemporised roles. It is entirely up to the prime minister’s discretion whether he or she even wants to appoint a deputy prime minister, and who it should be if they do. Johnson, for example, has chosen not to have a deputy but instead appointed a first secretary of state in the form of Dominic Raab, who also serves as foreign secretary.

Just as it was hard to imagine Harold Wilson actually vesting power in his own first secretary, the unstable George Brown, rather than his chancellor, James Callaghan, so one can now see Johnson’s chancellor, Rishi Sunak, prevail over Raab. Everything devolves to circumstance, and contingency; as Callaghan, the only person to hold the four highest offices of state, entitled his memoirs: time and chance.

One historical echo sounded by Johnson’s supporters has been framing this as his 1940 moment. Another precedent from 1940 is that, rather than merely the prime minister being incapacitated, the existential threat facing the country has the means simultaneously of incapacitating his colleagues. Johnson’s insouciant comments about shaking hands and visiting his mother sound worse than flippant now that a key minister has tested positive and the chief medical adviser is self-isolating with symptoms. Imprudent public remarks are one factor Johnson shares with Churchill; he will hope – as do we all – that they share others.

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