Boris Johnson in hospital is bound to destabilise the government

Long gone are the days when a prime minister’s doctor could expect to conceal any change in their patient’s condition

Boris Johnson remains in charge of the government, we are told by Downing Street, but the news that he is in hospital – even though it was not an emergency admission – is bound to heighten the sense of crisis.

“This is a precautionary step,” the Downing Street statement said. While some of the prime minister’s colleagues seem to have shaken off the infection, he continues to have a high temperature and a cough after 10 days.

Long gone is the time when a prime minister’s doctor could expect to conceal any change in their patient’s condition. News of Winston Churchill’s stroke in 1953 was withheld from the public, and the business of government was carried on by the small group of intimates around him.

Now, 67 years later, journalists were already asking about contingency plans before it was announced – by Johnson himself in an online video – that he had tested positive for the coronavirus. Downing Street had already officially confirmed that, if the prime minister became too ill to work, Dominic Raab, the foreign secretary and first secretary of state, would deputise for him.

Since Johnson was diagnosed, there has been much interest among journalists in the mechanics of how he has continued to run the government while in quarantine – although most of the general public seem quite relaxed about it, and many are now compulsorily familiar with the technology of remote working.

Alarm bells started to ring when the prime minister appeared unwell in his latest video missive on Friday. They rang louder as Matt Hancock, the health secretary, who had announced he had tested positive for coronavirus at the same time as the prime minister, returned to work full of vigour, taking the daily news conferences as well as the media round of the morning TV and radio shows.

The prime minister’s spokespeople could not confirm when Johnson would return to work, and, when pressed, admitted that he still had a fever. Today’s Sunday Times reported that Johnson had been “coughing and spluttering” on video conference calls.

No prime minister ever wants to admit physical frailty. Tony Blair went to elaborate lengths to distract attention from his surgery to correct a heart flutter, which was conducted under local anaesthetic, and during which, The Independent reported, “aides insisted that Mr Blair’s appetite for the job was undiminished”. He combined the announcement, in 2004, with the news that he intended to fight the coming election – dashing Gordon Brown’s hope of succeeding him before then.

All prime ministers are also aware of the cautionary tale of Harold Macmillan, who may have given up office in 1963 because he thought he was seriously ill (although he may have used it as an excuse to get out in the wake of the Profumo scandal), but who quickly recovered and went on to live to the age of 92.

Nor does any prime minister want to hand over the reins of power to a deputy, however briefly, for fear that it will be hard to get them back.

For the rest of us, there is the concern that the government will not be best able to manage the crisis if the prime minister is not at full strength, or if there are doubts about who is in charge.