The Prime Minister's little flutter

Statesmen deny illness for fear of alarming the public and keep on going. But far more worrying is a

Now that Tony has been a sensible chap and got his little health problem sorted out, he probably wants to draw a line underneath events and move on. And I'm sure we all wish him well in this aim. Yet, now 51 and approaching the age where such nuisances will crop up with greater frequency, he needs admonishing. He has dragged his feet most irresponsibly over this atrial flutter. Perhaps the name, redolent of frivolity, misled him. After all, his own cardiologist dumbed down the seriousness by dismissing it as an irregular heartbeat. Yet, besides sudden death, arrhythmias can cause such complications as blackouts and heart failure, embolic strokes, gangrene or renal compromise, to name but a few. This is not an illness to dismiss lightly and ignore for fear of causing a "national scare".

Yet Tony and his medical advisers are running true to type, the latest in a long tradition of statesmen denying illness for fear of causing public panic. I am not sure who these nervous members of the masses might be who would be sent hysterical by the PM being hors de combat. They seem to exist in the mind of any leader who ever became ill; in this delusion he is usually encouraged by those around him with much to lose: his family, close colleagues and, regrettably, his own personal doctor.

In 1941, with the US newly entered into the war, Winston Churchill fell ill with a pain in his chest and left arm. Lord Moran, his doctor, diagnosed a heart attack, but did not tell anyone, not even Churchill himself. So no steps were taken to protect him from fatal complications and recurrences. Moran adopted the same ostrich-like attitude when his patient suffered various strokes later. As he admitted, it was his job to see Churchill stayed in power and in office for as long as possible - as this was what he lived for - even if that meant idiosyncratic management. The meaning of medical responsibility and confidentiality in this kind of situation urgently needs to be debated, for patched-up parcels of polypathology such as Churchill, even in his war years, have undoubtedly made gross errors of judgement, with worldwide, century-long consequences.

In 1944, Franklin D Roosevelt decided to run for a fourth term as US president. He was terminally ill, according to the report of an impartial cardiologist, suffering malignant hypertension and heart failure. But his personal doctor chose to modify the language in the report and suppress the gravity of his condition to enable FDR to stand for re-election. Roosevelt failed in his crucial role of mediator at the Yalta conference, his mind so clouded that he fell asleep during discussions. We may never know how this affected the concessions wrung from the west by Stalin.

Statesmen have always more work to do and are programmed to go on and on, even while hinting otherwise. They interpret their tenacious inability to let go as burning themselves out in the name of duty. Woodrow Wilson, having exhausted himself at the Paris Peace conference, took on a campaign in 1919 to persuade the US to enter the League of Nations. He suffered a paralytic stroke, which was covered up by his wife, his aide and his doctor, who ran the country in his name in the months that followed. His secretary of state, Robert Lansing, quoted the constitution at them in vain, and was fired on the grounds of disloyalty.

Tony Blair is not the first leader to suffer and conceal a sinister health problem in the prime of life. John F Kennedy, in collusion with his father, covered up his youthful brushes with death from Addison's disease and the consequences of treatment - steroid-related back problems. He also denied his chronic venereal disease. His medical history was whitewashed in order to enable him to go into the navy and be heroic, as befits an aspiring president. As with many of the ruling class, he was addicted to a cocktail of mind-bending drugs; as were Churchill, Anthony Eden, Richard Nixon, Mao Zedong and Leonid Brezhnev. Just think of Suez, the Cuban missile crisis, Vietnam and the invasion of Czechoslovakia, all being directed by paranoid minds spaced out on psychoactive drugs.

Perhaps the worst diagnosis that a Messianic top man can receive is cancer. It sounds so unequivocally mortal. Georges Pompidou and the Shah of Iran, with myeloma and lymphoma, respectively, were utterly shattered to be confronted with a limit to their projected lifespans. Even their wives were kept in ignorance while they received chemotherapy and, in the Shah's case, antidepressants, too. Anyone who has coped with this treatment knows how even getting up in the morning becomes a monumental task. It is obvious that the best thing a national leader can do, faced with such a problem, is to quit.

But they don't. They cling on. We are advised that Blair has probably been cured, so there will be no call for him to go on health grounds this time. If history is any guide, however, we may be sure that neither he nor his deferential advisers will ever find failing health an adequate reason to call it a day.