"Loongate" shows some Tories want to be insulted by Cameron

There are Conservatives who need routine evidence of treason to justify perpetual rebellion against their leader.

There is a curious paradox to the commotion over alleged remarks from within David Cameron’s inner circle that Tory activists are all “swivel-eyed loons.”  The newsworthiness of a statement is normally defined by its being surprising or unusual. The scale of a gaffe is also conditional on the celebrity of its author.

"Anonymous person says precisely what such a person might well be expected to say" is not, under normal circumstances, a front page story. Except on this occasion the vagueness and predictability are precisely the point. There is a fuss because someone in the Prime Minister’s gang – and it doesn’t really matter who because we are supposed to imagine them as a homogenous clique of braying posh boys – said just the kind of thing they would say, wouldn’t they.

Very few people outside Westminster have heard of Andrew Feldman, the object of much speculation in connection with the offending remarks. He is not identified as the speaker in the original news stories and vigorously denies saying anything along those lines. He must, then, be presumed innocent. As indeed Andrew Mitchell deserved to be when he insisted he had never called a police officer a “f**king pleb.” (Some of us said as much at the time.) He is now vindicated.

But as in the “pleb-gate” case, the charge of swivel-eyed lunacy is deadly not because someone actually uttered that formula but because so many Tories want it to have been uttered. The essential charge that the embittered anti-Cameron caucus in the party levels against their leader is that he is not a genuine Tory. His treason has a number of steps. First, he led the party away from the policy preoccupations that traditionally give it moral nourishment – Europe, crime, immigration – with the claim that election victory would be the reward. Second, he failed to uphold his side of the bargain in the 2010 general election. Third, he exploited that result, which should have been his own personal humiliation, fashioning from disappointment a weapon to further punish his party faithful – coalition with the Liberal Democrats.

Viewed from a certain angle, and filtered through sufficient layers of thwarted ambition, this begins to look like a conspiracy. Cameron, it is supposed, must actively wish the truest and bluest section of his party ill. What has been missing to complete the grievance is evidence of malice. Strategic ineptitude has a certain redeemable quality. The path of righteousness is still available to the errant leader if he is open to persuasion, harassment and threat. (As it happens, Cameron has proved himself remarkable amenable to all three.) But a leader who despises his party – who speaks of it with supercilious contempt – cannot be cajoled. He is beyond redemption and must be replaced.

The reality is that a resolute hardcore of Tories, nurtured by the truculent mood in their local associations – and I pass here no judgment on the angle or rotation of their eyes – long ago passed from disappointment with Cameron to venomous hatred. That is probably an unreasonable response to man making tricky political calculations in complex circumstances. It feels more rational to hate someone, however, if it can be plausibly claimed he hated you first.

And it is in this psychological affirmation that the potency of “loon-gate” lies. Cameron definitely didn’t say it.  Andrew Feldman insists he didn’t say it. If anyone said it at all, the circumstances were a private dinner of the kind at which incautious remarks are often made by senior politicians about their rank and file. I once heard a very prominent figure in Ukip describe his own party as full of “people who have failed at everything else in life and are feeling angry about it and want someone to blame.”  I have seen plenty of Labour shadow ministerial eyes roll in despair at the views held by their own activists.

This alienation of the high command from the rank and file is as normal in political parties as it is in any large institution. One test of leadership is how the arising tension is managed and, in critical moments, eased. Cameron is dreadful at this bit of his job. Why? Partly it it is complacency that flows from his instinctive sense of entitlement. Given his background, there is no more natural vehicle for his ambitions than the Conservative party. Combined, those elements make it inconceivable to him that his Tory credentials could be somehow inauthentic. He is right, of course. If David Cameron doesn't count as proper Tory anymore, who or what does? It is the question to which Ukip fancy themselves the answer.

But the vast majority of Tories are still loyal to their party. They don’t want to be apostates or turncoats. Yet many want to carry on being Conservatives while also rejecting the elected leader of the Conservative party. Tricky. What they need is reassurance that such a sentiment is not rebellious or disloyal; that it is, in fact, a mark of decency and fidelity. They need, in other words, a sign that true Conservatism is antithetical to Cameronism – and what better proof could they have than an expression of withering scorn for true Conservatives from within the Prime Minister’s cosy cabal. Activists and members say they are outraged by the claim that they are mentally unhinged in some way. Justifiably, they feel insulted. Many are shocked. But many also feel vindicated; few are really surprised. The political force of this affair lies not in the wounding nature of the words supposed to have come from one of Cameron's chums, but in the voracious appetite of the Conservative party to feel wounded by them.

In what way is he not an authentic Tory? (Source: Getty)

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

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When it comes to the "Statin Wars", it's the patients I pity

Underlying the Statin Wars are two different world-views: the technological and holistic.

September saw the latest salvos in what has become known in medical circles as the Statin Wars. The struggle is being waged most publicly in the pages of Britain’s two leading medical journals. In the red corner is the British Medical Journal, which in 2014 published two papers highly critical of statins, arguing that they cause far more side effects than supposed and pointing out that, although they do produce a modest reduction in risk of cardiovascular disease, they don’t make much difference to overall mortality (you may avoid a heart attack, only to succumb to something else).

In the blue corner is the Lancet, which has long been the publishing platform for the Cholesterol Treatment Trialists’ (CTT) Collaboration, a group of academics whose careers have been spent defining and expounding the benefits of statins. The CTT was infuriated by the BMJ papers, and attempted to force the journal to retract them. When that failed, they set about a systematic review of the entire statin literature. Their 30-page paper appeared in the Lancet last month, and was widely press-released as being the final word on the subject.

A summary would be: statins do lots of good and virtually no harm, and there really is no need for anyone to fuss about prescribing or taking them. In addition, the Lancet couldn’t resist a pop at the BMJ, which it asserts acted irresponsibly in publishing the sceptical papers two years ago.

Where does all this leave the average patient, trying to weigh up the usefulness or otherwise of these drugs? And what about the jobbing doctor, trying to give advice? The view from no-man’s-land goes something like this. If you’ve had a heart attack or stroke, or if you suffer from angina or other conditions arising from furred-up arteries, then you should consider taking a statin. They’re not the miracle pill their proponents crack them up to be, but they do tip the odds a little in your favour. Equally, if you try them and suffer debilitating side effects (many people do), don’t stress about stopping them. There are lots more effective things you could be doing – a brisk daily walk effects a greater risk reduction than any cholesterol-lowering pill.

What of the millions of healthy people currently prescribed statins because they have been deemed to be “at risk” of future heart disease? This is where it gets decidedly murky. The published evidence, with its focus on cardiovascular outcomes alone, overstates the case. In healthy people, statins don’t make any appreciable difference to overall survival and they cause substantially more ill-effects than the literature suggests. No one should be prescribed them without a frank discussion of these drawbacks, and they should never be taken in lieu of making lifestyle changes. Smoking cessation, a healthy diet, regular modest exercise, and keeping trim, are all far more important determinants of long-term health.

Underlying the Statin Wars are two different world-views. One is technological: we can rely on drugs to prevent future health problems. This perspective suffers substantial bias from vested interests – there’s a heck of a lot of money to be made if millions of people are put on to medication, and those who stand to profit make huge sums available to pay for research that happens to advance their cause.

The other world-view is holistic: we can take care of ourselves better simply by living well, and the fetishising of pharmaceutical solutions negates this message. I have great sympathy with this perspective. It certainly chimes with the beliefs of many patients, very few of whom welcome the prospect of taking drugs indefinitely.

Yet the sad truth is that, irrespective of our lifestyles, we will all of us one day run into some kind of trouble, and having medical treatments to help – however imperfectly – is one of mankind’s greatest achievements. In arguing for a greater emphasis on lifestyle medicine, we must be careful not to swing the pendulum too far the other way.

Phil Whitaker’s latest novel is “Sister Sebastian’s Library” (Salt)

This article first appeared in the 20 October 2016 issue of the New Statesman, Brothers in blood