Mental Illness and Being PM

Via Old Holborn - where the article is reproduced in full - we have a long piece looking at the failing mental and physical health of our Prime Minister. The article itself makes for grim yet compelling reading. For those of us who have described the Brown administration as a car crash, this piece of writing shows far more accurately what may well be - the slow disintegration, the long mental breakdown of our incumbent Prime Minister.

Of course, it is always worth taking any article that uses anonymous sources so liberally with more than a pinch of salt. You can argue pretty much anything if you refuse to specify where you got your information from. It will always be to the detriment of your argument, though. Yet there is much in this article that has a ring of truth to it. Gordon Brown looks ill these days, and his behaviour is awkward, difficult and self-destructive. It is more than conceivable that there would be a conspiracy of silence around a mentally ill Prime Minister - a conspiracy based around a mix of embarrassment and political expediency. But there is a wider problem identified by this article - namely, what the hell happens if a Prime Minister is effectively disabled by mental illness?

The Reality of Mental Illness

Of course, we need to be realistic about mental illness in the first instance. The fact is mental illness is common. If you yourself don't suffer from mental illness at some point in your life, then statistically one of your family or friends will. Which means that there is a fair chance that the Prime Minister is mentally ill. And the reality is that he won't have been the only Prime Minister in history to have suffered from mental illness. The stats are clear: mental illness is common.

And given that mental illness is common, it should be stated that suffering from a mental illness does not mean that you are incapable of doing your job. People suffer from all sorts of psychiatric conditions and get on with their jobs and their lives. Remember, other Prime Ministers will have suffered from mental conditions. Yet they got on with their jobs, and we never really heard about those conditions.

Yet this isn't a denial that mental illness can be a serious thing. It can be just as destructive and potentially fatal as the most virulent forms of cancer. And the article suggests that the Prime Minister is suffering from an extremely limiting form of OCD and deep depression. The implication is clear; the Prime Minister is very sick, and not capable of functioning in the way his job requires of him.

So - if the Prime Minister is too mentally ill to do his job - what the hell can be done?

Serious Mental Illness And Power

First of all, let's dismiss the idea that we can somehow see warning signs that someone is becoming mentally ill and therefore not allow them to reach high political office. Because warning signs tend to be clear in hindsight. Take Brown. You could argue that his social awkwardness is a good indicator that his mental health was not so strong. Yet Clement Attlee was socially awkward, and Harold Macmillan was painfully shy. You could point to Brown's work ethic and argue that it isn't healthy; yet our first female Prime Minister had a similarly masochistic attitude to work. What about disloyalty, and Brown's paranoid desire to destroy political enemies? Well, that's a prerequisite for anyone seeking political influence these days. You can't withhold power from people because you think they have a predisposition towards mental illness, partly because those potential symptoms are very much in the eye of the beholder. It would be very easy to turn mental illness into a modern form of McCarthyism, where it is used as a political tool to clout the enemy rather than anything else. Plus, in all discussions on this subject, we need to be careful of stigmatising mental illness. Remember, the stats say a friend or a family member will be suffer from mental illness.

So what to do if someone in power is suffering seriously from mental illness? We have a recent example of a party leader who suffered from a such an illness (if you can class an addiction as a mental affliction) - Charles Kennedy. And guess what? Charlie K was removed from power. There was no formal structure for such a removal, but it happened nonetheless. It was a mix of party and popular pressure that meant Kennedy stood down. Yet a more detailed look at what happened with Charles is less comforting than it first appeared. Senior Lib Dems knew that Charles Kennedy was an alcoholic long before he went public. The media knew about it as well. Yet there was a conspiracy of silence. Greg Hurst's biography of Kennedy details just how cynical the decisions around Kennedy were after it became clear he had a serious drink problem. Why do you think he fell from power when he did? Because it was politically expedient. It was a long way away from the next General Election, so the Lib Dems could change leaders without it reflecting too badly on them. It had nothing to do with the good of Kennedy or of the Great British Public; it was all for the benefit of the Liberal Democrats.

Now, to a large extent it doesn't matter who is Lib Dem leader - whoever holds that position has bugger all reach and influence over the fabled corridors of power. What happens if the Prime Minister is mentally unwell? Because it isn't in the best interests of the Labour party to admit that the person they made Prime Minister through an internal Labour party coronation is not stable enough to continue as Prime Minister. Regardless of whether it is their fault or not, it is far more politically advantageous for the Labour party to insulate the Prime Minister from the public, and pretend everything is A-OK. This isn't in the best interests of the country, and leaves a vacuum at the top of the British political system. The Prime Minister is too powerful a position to have someone who isn't stable enough to cope in it.

Under these circumstances, maybe we can rely on those around the Prime Minister to minimise the potential impact that they could have from their powerful position. The example of Nixon at the end of his time in the White House makes for an interesting example here. As Nixon struggled under the pressure of Watergate, steps were taken to minimise his power by those around him. It will always be a matter of considerable historical debate as to whether Nixon had a breakdown before he left office, but various additional checks and balances were put in place in case Nixon chose to do anything destructive and irrational - in particular in relation to the US military. And nothing bad happened. Yet this is reliant on those around the person in power taking the initiative and minimising the scope of that incumbent's powers. Can we really trust Brown's cabinet - a group of naked opportunists like Balls, wet behind the ears kids like the Milibands, and spineless wimps like Alan Johnson - to do the right thing if Brown is falling apart? Or will they simply cower from his rages and hope for the best? Besides, how democratic and constitutional were the actions of the political appointees around Nixon?

What is needed is a rediscovery of what the office of Prime Minister actually is. He isn't meant to be a presidential figure wielding huge amounts of power. He (or she) is meant to be primus inter pares - first amongst equals. In the event of a physical or mental illness that disables the Prime Minister temporarily, the Cabinet and Parliament should be strong enough to take the workload until the Prime Minister recovers. In the event that the illness is too much for the Prime Minister to come back from, then the Cabinet and Parliament should be strong enough to take power from the PM - replace them with someone capable of doing the job. The upshot of the Brown, Blair and Thatcher administrations is that the PM has become far too powerful - and that is why a Prime Minister effectively succumbing to serious mental illness in this country is now such a worry and such a problem.

The post of a modern Prime Minister forgets a fundamental truth - that humans are fallible and fragile. Against a long enough timescale, some sort of debilitating condition is not just a likelihood, but a certainty. Yet the job of Prime Minister now almost requires a superhuman to fulfill it. Furthermore, the very nature of the job - isolated from the people and from contemporaries at the same time as being under incredible pressure - almost seems to encourage some sort of mental or physical deterioration. Given what it means to be Prime Minister, is in any wonder that Thatcher descended into hubris? Or that Major couldn't wait to get off the national stage in 1997? Of course Blair had heart problems, and Brown is on course for a nervous breakdown - they have an impossible job.

A Proper Prime Minister

Fundamentally, the job of Prime Minister needs to change. The scope of it needs to be reduced, and the expectations associated with it need to be restricted as well. You could say that the job of CEO of a plc is the right model for the modern PM, but all we need to do is change the role of Prime Minister back to what it used to be. The Prime Minister needs to be the Chair of the Cabinet. They should delegate the detailed work to Cabinet Ministers, and instead manage and co-ordinate the process of running the country. The buck stops with the Prime Minister; that doesn't mean that the PM should try to or be expected to micro-manage the whole country.

Whilst we're on the subject, something else that might ease the pressure on the executive branch of our government is reducing the amount of things they actually legislate on and take responsibility for. Brown is an example of a Prime Minister who tries to comment on everything going on; from the economy through to Jade Goody's death through to X Factor. We don't need a Prime Minister who does that, and we shouldn't want one either. It is all very well calling for a Prime Minister who is in touch with things; but the Prime Minister is meant to be a politician, so what we should expect he or she to be in touch with politics rather than anything else.

In short, we need to drastically reduce the scope, powers and responsibilities of the office of Prime Minister. At the same time we need to actually lay down who covers what within the Cabinet, at also redefine what our political class should and shouldn't be concerned with. Finally, we might want to consider some sort of succession plan so there is some sort of concrete idea of what happens if the Prime Minister suffers some sort of mental or physical breakdown.

Imagine the CEO of Sainsbury's had a massive nervous breakdown. They would be replaced, and the company would go on functioning. The reason why Gordon Brown's mental state is so terrifying is that if it fails, there is a massive void at the head of our government and the head of our country. What we should take from the rumours about Gordon Brown's mental health is the urgent need to reform the office of Prime Minister, rather than anything else.