The Queen had smiled broadly but appeared frail, gripping a cane in her left hand, as she greeted Liz Truss, the 15th prime minister of her 70-year reign, in Balmoral Castle’s drawing room on Tuesday.
An official photograph of the historic moment had also born witness to an ominous dark purple bruise across the top of the 96-year-old monarch’s right hand. Whether the result of a fall or perhaps the removal of a cannula, the palace was not commenting, and it had prompted public concern.
After all, the event was already a break from tradition in that the acceptance of Boris Johnson’s resignation and the “kissing of hands” of the new prime minister had taken place in the Queen’s Scottish retreat rather than Buckingham Palace or Windsor Castle. That decision, the palace had said, was due to the Queen’s “episodic” mobility issues. The following day, a further unusual announcement was made.
A virtual meeting of the privy council to be done via video link to allow for the swearing in of new cabinet ministers was to be postponed. “After a full day yesterday, Her Majesty has this afternoon accepted doctors’ advice to rest,” the palace said. “This means that the privy council meeting that had been due to take place this evening will be rearranged.”
By Thursday morning, the assessment from Sir Huw Thomas, the head of the medical household and physician to the Queen, was more grave. “Following further evaluation this morning, the Queen’s doctors are concerned for Her Majesty’s health and have recommended she remain under medical supervision,” the palace said. “The Queen remains comfortable and at Balmoral.”
The Queen, unlike her father – a heavy smoker who died of lung cancer at the age of 56 – has enjoyed robust health for much of her life, continuing to ride horses into her 96th year, even when against doctors’ advice. While fond of a gin and Dubonnet, her drinking has been moderate. Prince Philip quit his heavy smoking habit under her orders on their wedding day, and episodes of illness over her long life have been no more numerous or serious than could be expected.
There was a bout of measles contracted from a baby Prince Charles in 1949. A troublesome wisdom tooth was extracted in July 1982, and in 1993 the dutiful monarch reluctantly missed a Commonwealth Day service because of flu.
There was a broken left wrist in 1994 when her horse tripped during a ride on the Sandringham estate in Norfolk, and a knee operation in 2003 and again in 2004. And a case of gastroenteritis put the Queen in hospital in 2013.
It was only in 2016, aged 90, that time finally appeared to be catching up with the country’s longest-serving monarch when she was forced to use a lift, rather than take the 26-step royal staircase at the sovereign’s entrance, to enter parliament for the state opening. That year, the royal couple were also struck by a cold that rendered them unable to attend the Christmas Day service for the first time in 28 years. Two years later, the Queen underwent successful surgery to treat cataracts in one of her eyes as a day patient at the private King Edward VII hospital in London.
While fully supporting her husband’s decision to retire from public life in 2017 at the age of 96, there was never any question of the then 91-year-old handing over the reins to Charles. The pace of her work schedule, however, was inevitably slowing.
The Queen visited 117 countries during her reign, the equivalent to travelling 42 times around the globe, but in 2015 she and her husband made a poignant last royal trip abroad to Malta, where the couple had lived between 1949 and 1951, to attend a meeting of the Commonwealth heads of government. While that was one of 341 royal events that year, in 2016 the number of engagements was down to 332, and in 2017 that was reduced to 292. The following two years she had 293 and 295 engagements respectively before Covid made its mark on the royal calendar in early 2020. The couple went into isolation, but the Queen told the British public: “We will meet again”, in a special televised address on the pandemic in April 2020, echoing the words of Vera Lynn’s wartime song.
Yet, while the palace appeared at times to be loath to admit it, the last two pandemic-scarred years saw a notable deterioration in the sovereign’s health – particularly since the death of Philip on 9 April 2021. In October that year, the Queen used a walking stick at a Westminster Abbey service marking the centenary of the Royal British Legion – the first time she had done so at a major engagement.
A week later the palace cancelled a visit to Northern Ireland on the advice of doctors. The Queen was in “good spirits” but had “reluctantly accepted medical advice” to rest for the next few days, Buckingham Palace said. In fact, she had been secretly admitted to hospital for “preliminary investigations”. It was her first overnight stay in hospital since her bout of gastroenteritis eight years earlier.
The BBC’s royal correspondent, Nicholas Witchell, was among those critical of the lack of transparency. “We were led to believe on Wednesday by Buckingham Palace that the Queen was resting at Windsor Castle,” he said at the time. “And as we were being told that by Buckingham Palace, and of course we were relaying that to our viewers and listeners, and newspapers to their readers, in point of fact, she was in hospital undergoing what are now described as ‘preliminary investigations’.” There was no further explanation offered by the royal household.
A slew of further cancellations followed. The Queen would not travel to Glasgow to speak at the Cop26 climate summit in October 2021 but would instead film a short address for a reception of leaders. She implored those gathered to act to address the climate crisis: “The benefits of such actions will not be there to enjoy for all of us here today: we none of us will live forever.”
Until the last moment, it had been hoped the Queen would attend the Remembrance Sunday commemorations the following month but again the palace was forced at the last minute to lament that she would not make an appearance at the Cenotaph in London on 11 November after spraining her back. The Queen had missed only six other Cenotaph ceremonies during her reign: four times when she was on overseas visits – to Ghana in 1961, Brazil in 1968, Kenya in 1983, and South Africa in 1999 – and in 1959 and 1963, when she was pregnant with her two youngest children.
For the following three months the Queen carried out only light duties peppered with virtual and face-to-face audiences in the confines of Windsor Castle. That year’s Christmas Day speech was a moving one in light of Covid. “Although it’s a time of great happiness and good cheer for many, Christmas can be hard for those who have lost loved ones. This year, especially, I understand why.”
In February 2022, at her first major public event since October, the Queen celebrated her platinum jubilee, meeting charity workers at Sandringham House and cutting a jubilee cake covered in thick icing. “I think I might just put the knife in it,” she joked. “Someone else can do the rest.”
She had appeared in good health, if a little stiff. But a few days later there was the first acknowledgement from the Queen herself of her physical condition. Meeting the incoming defence services secretary, Maj Gen Eldon Millar, at Windsor Castle, she was asked how she was. Holding a walking stick, the Queen pointed to her left leg or foot and responded: “Well as you can see I can’t move.”
A few days later, on 20 February, the Queen tested positive for Covid. She had mild cold-like symptoms but the virus was said to have left her “very tired and exhausted”. She pulled out of the Commonwealth Day service at Westminster Abbey in March, a significant date in the royal calendar, and did not attend the Maundy Thursday service. But the Queen rallied to honour her late husband. A last-minute decision was made that she would lead her family at a memorial in Westminster Abbey for the Duke of Edinburgh. Leaning on her son, Prince Andrew, for support, she walked slowly to her seat.
Special arrangements had been put in place for the Queen’s comfort, with the service limited to 40 minutes and the monarch sitting in one of the Canada chairs but with an additional cushion. The TV cameras avoided filming her walk. Two months later, the Queen missed the state opening of parliament for the first time in nearly six decades.
The Prince of Wales and the Duke of Cambridge opened parliament on the sovereign’s behalf, with Charles reading the Queen’s speech for a historic first time.
Since then, royal appearances have been fleeting and sporadic. She attended the Windsor horse show in May and appeared as the guest of honour at the equestrian extravaganza A Gallop Through History, near Windsor, the first major event of the jubilee festivities.
There was a surprise 10-minute appearance to officially open the Elizabeth line at Paddington station and the monarch turned up at the Chelsea flower show in a hi-tech golf buggy.
The Queen is understood to have moved up to Scotland in July, as is a summer tradition, but it was announced that the welcome by the military at Balmoral would be done in private for her “comfort”.
The intention had been to travel back down to London for the change of prime ministers – but two weeks ago those plans changed. It was to be in Balmoral, said to be her favourite royal residence, where the Queen, whose first prime minister was Winston Churchill, carried out her final constitutional duty and asked Liz Truss to form a government – before retiring to rest.