Doctors Should Stick to Medicine — Not Wield Public Health as a Political Weapon They Barely Understand

In the British Medical Journal last month, an opinion piece by Professor of Respiratory Medicine at Imperial College London, Nicholas Hopkinson offered “a lesson from Nye Bevan on the roots of fascism”. “Far-Right parties are gaining ground across the world”, claims Hopkinson, who, in response, channels Aneurin Bevan, who is credited with being the founder of what has become known as “our NHS” while Health Minister under the Clement Atlee government, in the aftermath of WWII. But his rant wasn’t as much a lesson in history and politics, as much as an object lesson in physician’s incapacity to grasp them. 

I am often asked, given my strong views on climate policy and the fact that I am merely an arts graduate (politics and philosophy), how I dare to criticise “the majority of the world’s top scientists”. I am similarly criticised for my comments about air pollution policies – the alleged consequences of which are Hopkinson’s legitimate domain of expertise. The truth on both matters, however, is that I really have not stepped far from the scientific consensus on either issue, and such challenges do not come from people who care for precision in argument. And on both issues, it is activists – scientists among them – who not only stray from “The Science” but stray from science itself, eschewing debate and reason in the scientific process.

So it puzzles me that scientists are not asked for their credentials to speak about politics. Hopkinson might have read every biography of Bevan, who might just as well have founded a religion. But just as one must read a lot of scientific literature about contested theories on a scientific subject to understand that subject, one must read a lot of political argument to understand historical and contemporary politics.

Perhaps a scientist reading Hopkinson’s article wouldn’t notice that he doesn’t actually explain to the reader who or what the term “far-Right” actually pertains to, much less what their claims are. And they might not notice that the “far-Right” is very quickly elided into “fascism” by Bevan’s corpse. Worse, the scientist or physician reading Hopkinson’s claims wouldn’t notice his apparent contention that even fascism seemingly came out of nowhere and nothing: “economic and societal problems in the 1930s had been caused by the operation of private interests,” he claims, and that “governments were held responsible for failing to fix them”. They failed, and consequently a man with a funny moustache, among some other European characters, marched on.

An historian might struggle to swallow such a pill. For sure: political elites that are indifferent to the broader population’s needs beget radical politics at their own peril. “The more that governments seem unable or unwilling to improve the material conditions of people’s lives,” explains the professor, “the greater the risk that people will look elsewhere for solutions.” We can agree with him that the Government and its recent predecessors are not interested in the actual material needs of the population, health included. But consistent with all intra-establishment criticism of the establishment, the underlying claim is that the establishment did not assert itself early enough, hard enough, for long enough against the public, for its own good, to stop Covid, to stop climate change and now to stop “fascism” or “the far-Right”.

The idea that Mussolini, Hitler and Franco simply emerged out of the failures of state agencies to deliver public services against the excesses of what might now be called “the free market” is surely bunk. Were it so, that period of history would not have produced such extreme ideologies, in such deadly conflict, in order to overcome state failures. Much deeper historical forces were in play, in the aftermath of Europe’s civil wars and revolution, WWI, the Great Depression, the collapse of empires and so on. Ideologies that emerged from such intense flux cannot be explained as simply the expression of the masses’ grievances. Into the mix, rather than from the vacuum, we must understand the role of communism, of imperialism and militarism in general, of doomed historical settlements, of old orders collapsing…

No. The solution to “fascism” is far more simple. So simple, in fact, it could be a pill. “Improving population health is key to restoring the standing of democratic politics,” states the professor. Evidence of this claim is offered in the form of data, which shows that “areas that elected a Reform UK Member of Parliament in the 2024 UK General Election had a higher average prevalence of 15 of the 20 health conditions assessed than areas that elected MPs from other parties”. This is backed up by “research in Italy and the United States [that] has also shown a link between poor population health and voting for far-Right parties”. According to one paper, US counties that showed greater incidences of unhealthy lifestyles and chronic disease tended to vote for Donald Trump rather than Hillary Clinton in the 2016 general election. Accordingly, if better healthcare provision is delivered, then people won’t be so inclined to vote for “far-Right” candidates like Trump.

This can be achieved, claims Hopkinson, by more aggressive public health interventions. “Reform UK voters are supportive of public health measures,” he claims. According to polling for anti-smoking campaign ASH, 60% of Reform voters support the incremental raising of the age limit on tobacco sales, leading to its eventual abolition. Only “27% of target [formerly Labour-voting] Reform voters were concerned about infringements on personal choice,” claimed the report.

Ban smoking to stop Hitler? Well, Hitler at least would have approved. The Führer was famously anti-tobacco and a vegetarian. Perhaps, had he just been a little more focused on smokers than, say, Jews, might he have inadvertently improved the German population’s health, and thereby undermined his power to wage war? There’s a reason historians do not ponder this question. And there’s a reason we don’t turn to physicians for historical analysis.

“A healthy population is a cornerstone of economic growth,” claims the professor. “Inequality makes and keeps people sick,” he adds. But is that true?

It’s a very clumsy formulation. In the undisciplined leftoid’s perspective “inequality” and “poverty” are equivalents. But this form of socialism presupposes wealth creation and distribution as a zero-sum game: my wealth is your poverty. And a condition of “equality” does not equal a greater level of overall wealth – a less equal society might be better off, even at the bottom. As even German-Italian erstwhile socialist-then-fascist theorists observed in the 1920s, those who are tasked with enforcing equality invariably end up forming elites that were able to help themselves to more of their share of power and public resources. Better to accept the necessity of elites to manage bureaucracies than to resist the “iron law of oligarchy” with the false promises of democracy, argued Robert Michels. Elites such as professors of medicine? Bureaucracies such as those charged with public health? Elites whose conversations between themselves include using their power to influence political outcomes? Fascists – or at least fascist theorists – were not simply ignorant chancers, whose populism appealed to lowest common denominators. The professor would know it, and know the risks he now takes with his political thesis, had he read them.

What if economic growth, in fact, is the cornerstone of a healthy population? What if the professor has it upside down? What if wealth is, at the level of the population, better than any antibiotic? What if a wealthy population makes better choices for itself, and takes better care of itself, if for no other reason than there is more to protect and more to enjoy with greater wealth?

Such questions are rarely asked or answered because they do not suit public health bureaucracies and bureaucrats, even if they are professors of respiratory medicine. Yet he has the data in front of him, that things like poor diet and poor lifestyle choices are correlated with income much more strongly than they are predictors of “far-Right” sympathies. Perhaps he and his colleagues’ unhealthy interest in the relationship between health status and political leaning is not owed as much to their concern for the material interests and health of the population as much as making “health” a political instrument.

It’s certainly not reason that motivates the health-socialist. “The poorest 10% in society would need to spend 74% of their income to eat a healthy diet”, he claims, citing a 2021 report from the Food Foundation – one of the very many fake charities that exist to influence policy, but which are in fact merely outsourced bureaucracies occupied by elites, funded by governments and political philanthropists, which we refer to as the ‘Blob’. The report cites research that found that “for an adult to follow the ‘Eatwell Guide’, it would cost them an estimated £41.93 per week” – the ‘Eatwell Guide’ being five-a-day-style government public health guidance. Adjusting for other factors, the £41.93 represents 74% of the poorest 10%’s post-housing income. Simple enough, but the implication is that it would be cheaper for such unfortunates to eat unhealthy food.

No. A kilo of carrots can be bought from a middle-ranking UK supermarket for 69p. Potatoes are 66p/kg. Apples and bananas – both one of your five a day – are 16p each. And on it goes. Fresh food is not more expensive than any junk food in Britain, and any claim to the contrary is a simple lie. If there is an issue with the poorest 10% having to spend 74% of their income on food, it is that they have so little.

The answer from the professor of health socialism, then, is as predictable as it is dyscalculic: doctors must “demand rapid redistributive steps to end poverty, especially child poverty, including abolishing the household benefit cap and the restoration of proportionate universalism”.

Doctors would be better advised to keep out of politics, which they manifestly do not understand. To the extent that they are capable of recognising that there exists a strong relationship between wealth and health, they are bent on destroying wealth – to create that zero-sum game as the basis for health-socialism. “Denial of science, especially around health and the climate crisis, threatens human survival,” claims the professor, also a zealous advocate for Sadiq Khan’s Ulez policies, which have trapped people in their localities and destroyed countless small businesses. Similarly, tackling the non-existent “climate crisis” necessitates among other things rising prices and the destruction of wealth, leaving people unable to heat their homes, leading to the problems with damp and respiratory diseases Hopkinson claims expertise in, and the reduction of resources available for healthcare.

Hopkinson is no more for health than he is against “fascism”. He is simply protecting an elite bureaucracy from a challenge that is widely supported by the public, which is, ultimately, where his contempt is focused.