Intended for healthcare professionals

Observations Back to the Future

Memories of Thatcher

BMJ 2013; 346 doi: (Published 17 April 2013) Cite this as: BMJ 2013;346:f2434
  1. Richard Smith, director, UnitedHealth Group chronic disease initiative, and editor of BMJ until 2004
  1. richardswsmith{at}

A former BMJ editor reflects on what Margaret Thatcher’s years as prime minister meant for medicine and healthcare

My early years at the BMJ were bound up with Margaret Thatcher. I started as an assistant editor a month before she became prime minister in 1979 and was appointed editor just before she was dethroned as prime minister in 1990. I saw her only once, at a Queen’s garden party. It was after she’d been deposed, and what struck me was the messy line on her neck where her thick make up ended. It suggested frailty, perhaps foreshadowing the forgetful woman depicted by Meryl Streep in The Iron Lady.

My first association with Thatcher and health was the attempted suppression of the Black report. This was a report on inequalities in health commissioned by Labour when still in power from Douglas Black, a former president of the Royal College of Physicians. The attempt at suppression was farcical and guaranteed that the report gained far more attention than it would have done if published in the normal way. No Tory politician would use the word inequalities. “Variations” was the politically correct term. Similarly “rationing” was a non-word replaced …

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