Leo is an inner-city London child whose parents will not divulge whether or not they have given him the MMR vaccine. This would not be of any interest outside his immediate family circle but for the fact that his father, a Mr Blair, who resides at 10 Downing Street, presides over a government whose Department of Health vigorously promotes the MMR as a safe and effective vaccine. As a family, the Blairs are entitled to medical confidentiality, but for those in public life to what extent can privacy be ove
Anyone who succeeds in getting a public service appointment will undergo a medical examination before taking up the job, yet there is no such compulsion on the winner of an election to be vetted for physical or mental suitability for running a country and government. You need not be a doctor to realise that Pope John Paul II is not a well man and his slouching gait, slurred speech, tremulous left hand and waxy, monotonous facial features suggest that he has Parkinson's disease. By all accounts, he is as mentally agile as ever, but what if he were to develop dementia? How would the Church react to having a senile or incapacitated pontiff, and what constitutional arrangements exist for such a scenario?
Bush's pretzel
Chief executives of large companies need to be in the whole of their physical and mental health. If not, they may find themselves being sidelined or jettisoned in a boardroom coup. So what level of mental and physical fitness should we demand from leaders charged with making crucial national and international decisions, especially those who may have their fingers on nuclear buttons?
George W. Bush nearly choked on a pretzel recently. Objects which suddenly lodge in the windpipe, if not rapidly removed, can lead to hypoxia (lack of oxygen) and trigger potentially fatal cardiac irregularities. In the event of Bush's death, power would pass to Vice-President Dick Cheney, a man who has had cardiac bypass surgery and suffers from continual heart problems. Since taking office, he has been admitted to hospital a few times with what has been unhelpfully described as cardiac "events". Is it right that such a man be potentially loaded with the responsibilities of the presidency?
Boris Yeltsin was Russia's president for almost a decade. His unpredictable and occasionally embarrassing behaviour in public bespoke a fondness for vodka, most memorably in 1994 when the then Taoiseach, Albert Reynolds, charitably explained that his non-appearance on a stopover at Shannon Airport was due to "hypertension" (high blood pressure).
Physical or psychological infirmity may, but need not be, a barrier to a successful political career. Francois Mitterrand was president of France from 1981 to 1995 despite having advanced prostate cancer, although this was not public knowledge until near the end of his second term. Franklin D. Roosevelt led America out of the Great Depression although unable to walk unassisted, as a survivor of polio. Although prone to bouts of the "black dog" of depression and drinking a bottle of spirits a day, Winston Churchill steered Britain successfully through the darkest days of the second World War.
Blunkett's blindness
Nearer home, Eamon de Valera was functionally blind for most of his tenure as Taoiseach, and blindness has not prevented the British home secretary, David Blunkett, from doing his job. Deafness is a much greater impediment in politics. The Ulster Unionist MP Cecil Walker lost his seat in last year's general election. A contributory factor was a disastrous performance in a TV debate where he was clearly affected by deafness.
Acute or chronic illness may affect a leader's performance, especially if compounded by medication which may impair judgement. It is said that Napoleon was so discomfited by haemorrhoids at Waterloo that he made several poor tactical moves which cost him the battle. Mitterrand's predecessor but one, Georges Pompidou, died in office in 1974 from multiple myeloma. His bloated facial appearance in his final years suggested treatment with steroids, which can affect clear thinking and decision-making. The British prime minister Anthony Eden was ill with gall bladder disease for most of 1956 and this may have contributed to Britain's disastrous involvement in the Suez campaign of that year. His successor, Harold Macmillan, resigned suddenly in 1963 at the height of the Profumo scandal; he too suffered from prostate trouble. It has been claimed that Leonid Brezhnev was effectively brain-dead for many years, from a combination of mini-strokes and sedative medication, before his death in 1982.
On the other hand, medication may sometimes enhance performance. Margaret Thatcher in her heyday needed no more than four hours' sleep a night and had seemingly unending energy.This was attributed by Private Eye magazine to her alleged daily consumption of "horse's piss", an oblique reference to a form of hormone replacement therapy derived from the urine of pregnant mares. John F. Kennedy's bronzed complexion was not a reflection of good health but was due to the hyperpigmentation of Addison's disease, failure of the adrenal glands, which requires lifelong steroid therapy. Steroids promote appetite: JFK's appetite for food and, as we now know, other pleasures, was legendary.
Kennedy's headache
On a visit to Britain, Kennedy quipped that unless he had sex once a day, he would have a headache. His host Macmillan, who had his own problems, replied: "Dear boy, even the thought of having sex once a day would give me a headache!"
Political leaders are entitled to medical privacy, and there are ethical dilemmas if illness impairs their ability to function. Woodrow Wilson, US President from 1913 to 1921, had a major stroke during his second term and transmitted executive decisions from his bedside through his wife Edith, giving her an unhealthy influence in affairs of state. Given the all-seeing eye of modern media, such an arrangement would hardly be possible today, but given the reluctance of politicians to relinquish the drug of power, leaders will doubtless continue to conceal their infirmities where possible. Apart from having a medical equivalent of the MOT on our politicians, it seems inevitable that their physical strengths and frailties will continue to influence their decisions.