Evelyn Waugh's view on girth is among the plentiful reasons he would have been a liability to any Blairite think-tank. 'There is no respectable reason for wishing not to be fat,' Waugh wrote in a swipe at the kind of diet police responsible for the Government's consultation document on feckless eaters.
Reports of the leaked paper, to be debated at this autumn's party conference, suggest a fatwa on obesity. Overweight people and heavy smokers would have to sign a contract with their GP, agreeing to shed stones or give up cigarettes in return for treatment. Those who failed to keep their side of the bargain, or who missed booked appointments, could be denied free care.
The document itself falls short of advocating a pay-as-you-die scheme. While it talks about putting the doctorpatient relationship on a 'statutory' footing, it also says that the agreement would not be legally binding. And anyway, no doctor is going to debar people on grounds of kebab abuse. The suspicion is that this is just another dud bit of wishful thinking, like the home-school contracts devised to barter Mr Chips-style dedication on the part of teachers against impeccable classroom etiquette by borderline excludees.
Nor is the health compact a novelty. The Tories floated the same idea eons ago, in their forgotten White Paper, 'Health of the Nation'. So why the fuss? The whiff of nanny statism always guarantees headlines, but the row over contracts taps into deeper worries about obesity and food. The two concerns are curiously unlinked.
As the fattest nation in Europe, with 17 per cent of all 15-year-olds classified as obese, we are rightly worried about junk food. But we are much more concerned about junk scares. Water can be dangerous, according to a report reversing the health Gestapo's edict to drink two litres a day. Salami contains horse. The damp squib of a genetically modified crop debate has been hijacked by bogus fears.
Our national discussion is supposed to address issues ranging from possible environmental fall-out to planning blight on rural homes. Will chaffinches plummet from the skies if GM goes ahead? Will house prices? It is hard to know, when even the vital question of what the crops can offer developing countries is eclipsed by paranoia about GM food.
The Royal Society has declared it safe to eat. Frankenstein tomatoes are, to mutate a metaphor, a red herring. But still there is terror among those who think any product not personally endorsed by the Prince of Wales is packaged suicide. Obviously, the sensible citizen should take reasonable dietary precautions. Those wishing to avoid Sars should, for example, resist snacking on civet cat, the delicacy held responsible for spreading the disease.
But genuine risk has little to do with anxiety. Instead, what not to eat has become the phobia of the thin middle classes. For vicarious gluttons, eating is a spectator sport extending from TV chefs to watching Phil Tufnell dining, like Diogenes, on insects. The health-phobic are always wondering why junk food addicts and smokers don't apply rationalism to death-wish behaviour, but bingeing on Jamie Oliver while living off rocket and Ryvitas is not a logical position, either.
If fat and food are psychological issues, they are political ones, too. Tony Blair, lean and hungry as Cassius, attributes his energy to his exercise regime. Leo trundles his toy trolley of fruit round Number 10. Cheriegate, which centred on Mrs Blair's lifestyle and slimming guru, Carole Caplin, was a scandal founded in the quest for well-toned thighs. Gordon pounds the treadmill, Alastair has done the marathon, and female members of the Cabinet sign up for late-night pump classes. This government has the tautest abdominals in political history. Whatever its flaws in failing to shift other people's flab, its efforts on its own behalf cannot be faulted.
Food, as anti-globalisation author Eric Schlosser says, can reveal more about a nation than its art or its literature. Its cultural weight cannot be measured in mere kilos or broken down into E numbers and emulsifiers. Its moral value was gauged by Voltaire, who categorised bad eating habits as a 'species of disease'. If philosophers can play Dr Atkins, then so can politicians. The trouble is that they are not so much leading by example as emphasising the gulf between the fit and the fat; the privileged and the deprived.
For the first time, poor people in post-industrial countries are more likely than the affluent to be seriously overweight. The gap between the rich and the impoverished expands along with the latter's waistlines. The resulting killer epidemic is most pronounced in the US, but we are not far behind; 31,000 British deaths, or six per cent of the annual total, are obesity-related, and smoking kills 250,000 a year. In both cases, the links with poverty are irrefutable. More than half of unskilled women in their early thirties are smokers, compared with one in 10 professionals.
Inequality does not stop there. A chain-smoking editor will live for longer than a chain-smoking dustman. Criticising a banker built like a prize Charolais would invite the charge of body fascism, while a 20-stone benefit-claimant is likely to be seen, by the let-them-eat-carrots lobby, as a self-indulgent slob.
The GP contract idea now up for debate raises other dilemmas. Should the thin murderer get better treatment than the pillowy home-help? Should the single mother whose bus was cancelled incur the same penalty for a missed appointment as the man whose Savoy Grill lunch overran? And why do smokers deserve to be punished when the £7 billion they contribute to the Exchequer in tax each year far outstrips the £1.7bn spent on treating their ailments?
Such questions mask the fact that Tony Blair has already entered into another contract. Last November, he took personal charge of reducing the health gap between rich and poor, guaranteeing to put progress 'at the heart of government policy'. It is a tricky pact to honour. When risky behaviour is influenced by factors more complex than personal choice, the pulic-health gospel cannot be sold be coercion.
Success demands fairness and, specifically, incremental changes, such as lettuce for school dinners and persuading food companies to lower salt, sugar and fat. 'Eat less and exercise more' works for the healthy middle classes. Thai spas do it for Liz Hurley. Neither message has much to say to a McDonald's generation deprived of playing fields. Most people will acquire healthy behaviour only when it seems natural, rather than another penance.
Far from achieving this transformation, Labour's dieticians may be making things worse. A King's Fund report out last Thursday says that better patient choice risks being achieved at the expense of the neediest. The fund's chief economist, John Appleby, claims, damningly, that the Government has already 'failed to place equity at the heart of its concerns'. In other words, the rich, the mobile and the powerful do the choosing while the poor get fatter and wheezier.
Worries that Labour's pills-for-promises contracts may one day disadvantage patients who refuse to diet or quit miss the point. They are already being punished by a system propagating the ills it seeks to cure.
