What Thatcher’s response to the AIDS crisis teaches us about tackling the present pandemic

1 Dec

“There is now a danger that has become a threat to us all,” the soundtrack begins. “It is a deadly disease and there is no known cure…”

A volcano erupts, a hail of boulders rains down a cliff, and to the sound of wild, funereal music a pneumatic drill and a chisel carve from the solid rock a tombstone bearing the single word AIDS, on which a bunch of lilies is thrown.

This must be one of the most frightening public information films ever made, directed by Nic Roeg, voiced by John Hurt, and intended to strike fear into viewers and get them to read the “Don’t Die Of Ignorance” leaflet which was distributed to 23 million households.

On World AIDS Day, it is worth recalling that in the 1980s another pandemic struck: a lethal and mysterious illness for which there was no cure.

The parallels between AIDS and Covid-19 should not be pushed too far, but are nevertheless illuminating, and in the fulness of time have even become encouraging, for the HIV Commission today publishes its plan for England to become by 2030 the first country in the world to eliminate the transmission of the HIV virus, which causes AIDS.

The Commission’s key recommendation is “test, test, test”, and as one of its members, Steve Brine MP (Con, Winchester), yesterday told ConHome, “in the context of the last nine months, you really get what we’re saying”.

Both pandemics struck during periods of Conservative government, and posed enormous troubles for the Prime Minister of the day.

In August 1975, when there had been 206 confirmed cases of AIDS in the United Kingdom, of whom 114 had died, Margaret Thatcher was told by the Chief Medical Officer, Sir Donald Acheson, that it was likely AIDS could be transmitted heterosexually as well as homosexually.

What message was to be given to the public? In his brilliant account, beginning on page 71 of Herself Alone, the third volume of his life of Thatcher, Charles Moore quotes David Willetts, then a member of Thatcher’s Policy Unit, who told her, “We have to walk a difficult tightrope between being accused of bureaucratic inertia, and being so active as to whip up public hysteria,” and went on:

“We simply don’t know whether everybody with the virus will eventually go down with the symptoms of the disease. So we would be telling people that they may get the clinical disease, but we don’t know; and if they have got it, we can’t cure it. That’s not a very satisfactory message, but seems to be the best course out of several unattractive alternatives.”

The problem was rendered still more difficult by the close association which emerged between AIDS and homosexuality. Some people seized the chance to express the disgust and hatred they felt for homosexuals: as Willetts warned, there was a danger of fomenting public hysteria.

Some Conservatives, and some religious leaders, urged the Prime Minister to preach the virtues of abstinence.

Thatcher declined to treat AIDS as an opportunity for moralising. For her it was a scientific and medical problem. As Moore writes, she was happiest “when she had a concrete and exact point to advance”.

She was a Tory pragmatist: she wanted to solve the problem, not prate about it. Those who have insisted on understanding her in ideological terms have often overlooked how practical she was.

But part of being practical was framing a public message about the dangers of anal sex, and here she took some persuading, which was done by the Health Secretary, Norman Fowler, who in March 1986 told her that the advice to avoid anal intercourse, “which has been linked with 85 per cent of AIDS cases so far”, must remain in advertisements to be placed in the press, or else these would lose all “medical authority and credibility”.

Lord Fowler, who has worked to this day to reduce and at length eradicate HIV, has recalled how difficult things were in the 1980s, and why at the start of 1987 a yet bigger public health campaign, which included the television advertisements, was warranted:

“We had no knowledge of this disease and no drugs with which to treat it. I was reading a note the other day from the Chief Medical Officer at the time and some of the predictions as to what could happen were terrifying – we were talking millions and millions of people becoming infected. That’s why we launched what is still the biggest public health campaign there’s ever been in this country with leaflets sent out to every home.”

In the 1980s, the predictions of the scientists did not always prove accurate. So too today. Nevertheless, Boris Johnson and Matt Hancock prefer to present themselves as following the science, than as adherents of a theory of freedom which would allow them to ignore what the scientists were saying.

They too are Tory pragmatists, most interested in what works, even if that has to be discovered by an agonising process of trial and error.

Thatcher was always worried, and with good reason, that although she and her colleagues insisted “the Health Service is safe in our hands”, the voters would not believe them. Johnson can be seen guarding at every turn against that danger.

Caroline Slocock, the first female private secretary at Number Ten, has described a visit Thatcher eventually undertook to an AIDS hospice, without any press in attendance, partly because she did not wish to seem to be competing with the well-known work already done in this field by Diana, Princess of Wales.

The first patient she sees is clearly “very ill and has no hope of recovery”. Slocock goes on:

“I feel out of my depth. I have never been at the bedside of a dying person before and I feel strongly that family and friends should be there at this moment, not us… She [Thatcher] responds by taking a seat by his side, asking questions, expressing sympathy, connecting in a simple and genuine way, to which he responds sweetly. She comes across as more of a mother than a Prime Minister…

“After about ten minutes, we leave him and go into the second room. Inside, sitting in a chair beside his bed, is a young American man, also extremely thin. The virus has attacked his brain too, as it does in the final stages, we are told afterwards, and he is excited and confused. At first he thinks she must be a creation of his own mind, a delusion. But then he begins to believe that she really is Margaret Thatcher, but sent to him miraculously to hear his thoughts and to pass them on to President Bush. He tells her to ring the President. It is imperative that action is taken now to help people like him – that is his message. He is overexcited, it is very difficult to know how to respond, and it is very, very sad.

“I desperately want to get out of the room. I feel responsible for putting them both through this awkward scene. Margaret Thatcher is unfazed and behaves as if she has all the time in the world. She places her hand on his arm, asks him a few questions about his life and listens, in a way that demonstrates that she is real, not a phantom, and is there because she cares and wishes him well. He calms down in response. It is simple, human stuff, but I am in awe of it.

“When we leave them, we ask the staff about their families. It turns out that neither have felt able to tell their parents that they are gay, let alone that they have AIDS, and so they are dying alone.”

For a quite different reason, the need to prevent infection, many sufferers from Covid-19 have lived and died alone.

While reading about the 1980s, it struck me that there was often no correlation between a politician’s views on other questions, and what he or she thought about AIDS.

This elementary point has sometimes been overlooked in coverage of the present pandemic. The urgent need to get things done, in order to avert or relieve suffering, trumps whatever abstract views one may have about the right way to set about this.

In January 2019, when Steve Brine was serving as Public Health Minister, and three charities – The Elton John AIDS Foundation, National AIDS Trust and Terrence Higgins Trust – came to him with proposals for the eradication in England of HIV, he gave the Government’s support and approval to what they wanted to do, as did Matt Hancock, the Health Secretary.

Brine said yesterday:

“We had a policy decision, we had the science that allowed us to approve it. The science of PrEP [Pre-Exposure Prophylaxis], which has been a huge game-changer, now allows us to finish the job.”

A connecting thread of pragmatism links the 1980s to the present day. Lord Lexden, the Conservative Party’s official historian, traces this tradition of unmoralistic pragmatism further back:

“‘Sanitas sanitatum, omnia sanitas’: Disraeli’s famous misquotation from the fourth century Vulgate in the course of his great three-hour speech in Manchester in April 1872 defining modern conservatism rings down the years. He understood that moral censoriousness had no more place in health policy than in private life. In this respect, Boris Johnson, like successful Tory leaders before him, follows in the great Disraelian tradition.”

Ben Monro-Davies: “I think when women cry, often they are angry.” On this day, 30 years ago, Margaret Thatcher resigned

22 Nov

Ben Monro-Davies is an Executive Producer at Sky News and has previously work at the BBC and Channel 4 News. He is the host of the podcast Big Ben History, which discusses the past at Westminster.

All remember it vividly. They arrived not entirely sure what was about to happen, awaiting her in the ante room. Her Principal Private Secretary, Andrew Turnbull, briefly panicked: he’d forgotten to tell ministers the right time, such was the silence as he and the soon to resign Prime Minister approached. But as they turned the corner – he and she saw them all there – in his words, “pressed back, looking at their shoes.”

The meeting was earlier than usual – bought forward not because of the end of an eleven year premiership – but for the memorial service for Libby Douglas Home, the wife of Alec. Many went straight to St Paul’s Cathedral afterwards – William Waldegrave remembers the surreal juxtaposition of them singing All Things Bright and Beautiful with the choir just an hour afterwards.

Some had anticipated what was about to happen. The Cabinet secretary, Robin Butler, realised the night before that it was all over. He was keen to “stage manage” proceedings. “I didn’t want there to be a hiatus with nobody knowing what to do.” On November 21st, he drafted a tribute on behalf of the Cabinet – and asked James Mackay, the Lord Chancellor, to read it. He chose Mackay as someone who was clearly not going to succeed her.

Lord Mackay – today still active in the Lords in his nineties – reflects that he, the son of railway signal man, had “strangely enough become number two in the cabinet, and I was sitting next to the Prime Minister.”

He remembers Thatcher reading her statement and breaking down. Cecil Parkinson spoke up, saying: “the Lord Chancellor will read it for you.” Two members of her staff, Barry Potter and Dominic Morris recall Parkinson adding “you don’t have to do this”. Mackay says he responded firmly: “no : the Lord Chancellor will not read it for you, The Prime Minister will read it herself.” Others recall her stumbling to the end – and then saying “I had better do that again”, and reliving the grief once more.

When I first became interested in this most dramatic of meetings, I’d assumed that was that. With a twenty-first century sensibility towards job termination, it already required imagination to grasp a scenario in which you’d have to read out your resignation to the men who’d called time on your career the day before.

But the meeting was not over. It was still a Cabinet gathering with an agenda. So with some ministers such as the Home Secretary, David Waddington, in tears, the meeting moved on – albeit with some constitutional as well as emotional awkwardness.

Her Party Chairman, Kenneth Baker, remembers a break for coffee, and a revived Iron Lady then telling the cabinet “on no account must Heseltine be elected” – an instruction he calls “inappropriate”. That was exactly what some of those in the meeting did want. Butler felt obliged to “soften” the Cabinet minutes to record a general exhortation to carry on the work of her government.

Tom King, then Defence Secretary, was moved by the scene. He’d found her very supportive during his time in Northern Ireland office, and remembers her kindly taking him aside after his mother died. By contrast, he doubts his previous boss, Ted Heath, ever knew his name. He also considered himself as the possible next Prime Minister. “The truth was at that moment four or five of us could have come through as her successor. That’s the reality. “

But he was also next on the Cabinet agenda – outlining the biggest military deployment since World War II to remove Saddam Hussein from Kuwait. This was effectively a war cabinet meeting, and the British machinery of government was navigating the defenestration of its leader and a massive military engagement at the same time.

The less historic was attended to as well. No-one understandably remembers, but in her memoirs Thatcher describes an item on “an unsuccessful Fisheries Council ruined by incompetent Italian chairmanship”. It’s confirmed in the minutes. The State was remorselessly executing the tasks in hand,

There were only two women in the room: Thatcher, and Caroline Slocock, then a private secretary in Downing St. She was not politically sympathetic to Thatcherism, and to her disappointment had been denied the position on a permanent basis. She later discovered that Thatcher had been behind this.

Nevertheless, she remembers the meeting as “pure torture. I was only the other woman in the room. To my shock I started to cry. I hadn’t even brought in a handkerchief. It was the extraordinary loss of power. “

But as a woman, there was another perspective. “It was also the anger. I think when women cry, often they are angry. I think she was probably very angry with these men. The scene has haunted me ever since.” By the end of that day, she recalls there being no tissue paper in the women’s bathroom.

Slocock was right. Thatcher was angry and made little secret of it afterwards. Peter Lilley thinks he was the only cabinet minister present at the launch of her memoirs which eviscerated her former colleagues as “men in lifeboats”.

As to how it had come to this, there are the common observations that longevity breeds detachment. Having so often been proved right at the ballot box, it became harder for her to accept she might be wrong, most notably on the poll tax. Lilley feared she might ask him to rescue it, and warned his wife he would have to return to the backbenches because he believed the policy wrongheaded.

But more bespoke episodes are identified. All bring up a cabinet meeting just a few days before, where she humiliated Geoffrey Howe needlessly over an issue of the parliamentary timetable. Malcom Rifkind says “he was the Deputy Prime Minister and she tore him into as if he were an errant schoolboy. That was a disgrace.”

Howe resigned shortly afterwards, triggering the events that led to a leadership challenge from Michael Heseltine. Charles Moore in his authorised biography of Thatcher concludes that Howe was going to resign anyway. But in two Cabinet meetings in November 1990 ministers spent much of it, in Kenneth Baker’s words, “staring at the blotters on their desks.”

And one name forgotten name comes up again and again. Peter Morrison was her Parliamentary Private Secretary who was tasked with her leadership campaign. Michael Howard says: “He was frankly hopeless. I remember ringing Peter up, and asking is there anything I can do to help? ‘No, no, no he said, it’s all under control old boy, there’s nothing you can do.’ It was a disaster.” Morrison was an alcoholic who died five years later, and the current Independent Child Sex Abuse inquiry has heard claims that he was also a sex offender.

Thatcher was forced into a fatal second ballot by a handful of votes – hearing the news In Paris at a conference with world leaders to mark the end of the Cold War. She’d played a crucial role in defeating the Soviet Union, but neglected to appoint the right general to deal with her own troops. Barry Potter blames a weakness for “posh men.” Andrew Turnbull adds she liked them also to be “tall.” Morrison fitted both categories.

And for all the drama of the final cabinet meeting , it’s worth noting the absence of three central actors. Michael Heseltine was of course challenging from the backbenches. Geoffrey Howe was there with him, for the first time since 1979. And the Chancellor of Exchequer was also missing. John Major was at home recuperating from having his wisdom teeth removed. The next cabinet meeting he attended was as Prime Minister.