A DOCTOR'S NOTE

It has been a bad month for the British State. The Duke of York's colourful private life and prat like behaviour finally caught up with him with the decision of a US court to press ahead with a civil (but not yet a criminal) indictment for his alleged sexual assault of an under-age woman of whom he claims no recollection. With an eye to the preservation of the dynasty rather than any individual member of it, Her Majesty was finally persuaded to act with ruthlessness and to defenestrate her boorish "favourite son". An easy scalp, the press sententiously declared he had "been found guilty in the court of public opinion". Nonetheless, the royal family's connivance with the media's almost gleeful abandonment of the principle of presumed innocence is one that it might later come to regret. It is not a great start to the Diamond Jubilee year.

A concurrent kerfuffle came in the shape of "Party-Gate", which has generated a more justifiable amount of confected outrage. As with the Duke of York, the media has gone all- in on this story and the "impartial" BBC news team seems to have taken an even more overtly political stance in its own right. But the government's reaction to a mess of its own creation has been quite pathetically inept, and the Prime Minister's attempts at exculpation have demeaned his office as well as the intelligence of nearly everyone else. In a craven attempt to swerve accountability, a judgement on the whole fiasco has been outsourced to a civil servant. Yet by deferring to Sue Gray of the Cabinet Office, Johnson is making the same high risk wager as did Nichola Sturgeon when she passed the decision as to whether or not she broke the ministerial code to James Hamilton. In each case, the bet is that no civil servant or establishment law officer is going to bring down a sitting Prime or First Minister. But Sturgeon is a far more skilful and articulate dissembler than is Johnson, who has been publicly disowned by even his own party north of the border.

Nonetheless, the hypocrisy and sanctimony of those now crying "foul" leaves as nasty a taste. Her Majesty's Opposition has put on its crocodile suit and tearfully exploited all those separated from loved ones by the over-the-top regulations whilst BoJo and his office minions were getting wasted in the Downing Street garden. Yet if memory serves, was it not Starmer and all the other ayatollahs in his party who were demanding even stricter and more demented lock-down measures at the time? And was there no police officer (of which there are quite a few swaggering around Downing Street, ludicrously dressed as if for an imminent assault), with the gumption to warn Number 10 of the illegality of its jolly? After all, the rozzers were being pretty punctilious in fining lockdown "breakers" everywhere else. And what did those others in Downing Street with positions of power and responsibility think they were doing? It has been seemingly forgotten that the Cabinet Secretary recused himself from an earlier enquiry on the grounds that he too had attended a lockdown busting knees-up.

Another nadir of sorts was also reached in the unlikely setting of King's College Hospital in London, where the Health Secretary Sajid Javid was faced down by a critical care consultant. Dr Steve James  told the minister (in no uncertain terms) that he was not going to get vaccinated against Covid, and deplored the policy of compulsory vaccination for healthcare workers, on pain of dismissal. Absurdly off guard, Javid bobbed his head in a placatory sort of way. Evidently, the exaggerated politeness with which well-mannered politicians used to treat bishops and clergymen, even when they were talking utter cobblers, has now been quietly transferred to quite junior medical professionals. Yet the minister's deferral to the articulate specialist seemed more like an act of cowardice than a display of social grace. It was either that, or Javid was simply not on top of his brief. For any other minister with an ounce of salt would have given Dr James both barrels, and it was noticeable that not one of the nurses or other medicos at the scene sprang forward to endorse the good doctor's opinion. Indeed, KCH later put out a weaselly worded statement, distancing itself from their employee's assertions. Yet James has now been hailed for his "plain speaking", is an instant You-Tube "sensation" and has been given further airtime to promote his disobedience and to claim that his "bodily autonomy" has been threatened.

In the first place, was Dr James right to speak out so publicly in a professional rather than private capacity? He is after all employed (if indirectly) by the state and has a role for which public confidence is essential. Back in the late 'eighties and only three months away from leaving the British Army, I buttonholed the Armed Forces Minister who had come to lunch in the Officers' Mess. With others sycophantically murmuring around this senior member of the government, and deciding there was nothing to lose, I firmly criticised the Poll Tax (hardly a military matter), which was within a year of being introduced in England & Wales and which had already made a very inauspicious start in Scotland. The Tory politician listened politely and did not even try to refute my argument that the tax was both highly regressive and at variance with the established principles of national taxation. Happily for him, there were no cameras present, but he was clearly discomfited enough "to have a word" with his host later. My embarrassed boss was absolutely furious and made it clear that my outspokenness would have done great damage to my career prospects had I been staying on. The reprimand was upsetting, but of course he was absolutely right. It was not that my view was either rudely expressed or necessarily incorrect, but who in his position would want to risk such an instance of a loose cannon going off when the real bullets were flying about?

These are different times and far different organisations, but were even the assertions of the critical care consultant correct? Dr James immediately tried to claim the moral high ground by saying that there was no "scientific" basis for compulsory vaccination, ergo the minister was an idiot. He declared that there was limited difference in infectiousness between the vaccinated and un-vaccinated and that "scores of studies" had show that "broadly speaking" natural immunity was equivalent to the immunity provided by vaccines. He couldn't deny that being unvaccinated "is a huge risk for some" but seemed much more certain of his untested hypothesis that having had an asymptomatic infection himself, he was unlikely to be laid low in the future.

James is not the first person "following the science" in the Covid crisis who has confused risk with uncertainty. Indeed their conflation at the highest level of government  has done a huge amount of avoidable damage at enormous cost. But nor do his other assertions about public policy have a basis in either logic or fact. After all, no minister has yet denied the infectiousness of Covid and the primary purpose of the vaccination program has been to protect the vulnerable from life threatening illness. Further, lockdowns were initiated at the express demand of a healthcare establishment which doubted the natural immunity, by which James sets such store, could be achieved before the NHS was overwhelmed. None of this seems to have cut much ice with the consultant, however. Yet if Dr James is eventually laid low by the virus, who is going to fill in for him in a service that we are repeatedly told is at "breaking point" by the very practitioners whom James claims to represent? Certainly, many fair-minded people would think it highly irksome that folk should continue to suffer restrictions of life and liberty so that a minority may maintain their "bodily autonomy" by refusing the vaccine. That they should have to do so to protect the scruples of a minority of critical health care professionals like James would strike most as outrageous. The consultant himself admitted that the vast majority of those people with Covid clogging up scarce ICU resources had not been jabbed, yet seemed to think that the issue was not that they were unvaccinated but rather that they were fat. In Dr James's universe, physical shapeliness and the currently fashionable neologism of "bodily autonomy" would seem to trump all other medical indications. 

When are people, not least the grown-ups, going to wake up? The idea, assiduously promoted by the BBC, that it is the Prime Minister who is responsible for all our discontents is as fatuous as it is misleading. Johnson is certainly an amoral narcissist, and although highly intelligent, he seems far too idle to master his complex brief. Yet other Prime Ministers have also shown many of these defects. The difference is that those like Lloyd George and Wilson surrounded themselves with men and women of the highest intellectual calibre who, critically, realised that no government (not even a socialist one) could aspire to do everything. They were also served by senior officials of equally high ability and even greater probity. Can anyone with any knowledge of the heart of UK government truly say that now? 

The government and practice of governance in the UK is today faced by the equivalent of the seventeenth century Fronde in France. A rebellion by the noble and judicial elites against the authority of the young Louis XIV at a time when the nation was also locked in battle with Spain, the Fronde was an existential struggle which the royal government simply had to win if the early modern French state was to survive. Nicola Sturgeon may unfairly grab all the headlines in the debate about the durability of the UK, but the real threat comes from a public sector that is not only far too large to manage, but which is now totally out-of-control. Hearing it from the teaching unions, the BMA, the NHS Confederation, UNISON, the police, UK Border Force, the MOJ and the Foreign and Commonwealth Office, the provision of paid for public service in the UK is now entirely at the discretion of the state employee. If the likes of Doctor James become the approved yardstick for the behaviour of public servants, we are in deep trouble.