Richard Berthelsen: What the Queen's latest health setback means for the monarchy

Queen seen standing, smiling at Windsor Castle The Queen was shown standing and smiling while meeting Britain's most senior uniformed military adviser at Windsor Castle.

TORONTO — After stating that it was the Queen’s "firm intention" to attend Remembrance Sunday in London, it was a surprise and concerning that that the palace announced - with one hour to spare - that Her Majesty would be unable to attend. It was understandable that, with a sprained back, it would be difficult for a 95-year-old to travel more than 50 kilometres from Windsor Castle, stand on public display as well as meet the diplomats and others involved to participate in this Royal fixture in her diary.

A few weeks ago, the Palace had given every indication that the Queen would attend what is the most important annual day of commemoration for the Royal Family and the Commonwealth. The Queen’s schedule was cleared in the weeks leading up to this weekend, including not attending the Festival of Remembrance last night, to conserve her strength. As the Queen was seen driving around Windsor as well as taking a weekend away to Sandringham, it suggested that she was on the mend from health difficulties announced in October.

As head of the Armed Forces, and the last remaining head of state with direct experience of the Second World War, it is disappointing and sad that the Queen was not able to attend. Only on six other occasions throughout her reign has she been absent from this Sunday ceremony, due to travels within the Commonwealth and during her pregnancies in 1959 and 1963.

Since 2017, the Prince of Wales has laid the Queen’s wreath on her behalf, given the challenge of walking backwards from the cenotaph on uneven pavement. The Queen has watched from a balcony with Prince Philip, and more recently alone, as the two-minute silence is observed along with the familiar rituals of remembrance. Today was the first time at which no wreath was laid for the Duke of Edinburgh, given his passing in April.

There continue to be concerns and disquiet about the Queen’s health, and it would have gone a large measure to reassuring the public had she been able to attend today. While the Palace was originally not transparent about the Queen’s condition when her trip to Northern Ireland was cancelled on Oct. 21, as it was later revealed she had spent an evening in the hospital for tests, information has been more forthcoming in recent weeks. The statement this morning identified the ailment which prevented the Queen’s attendance. It is not clear if this is related to the earlier health issues. The Queen’s reticence to reveal personal health details and her desire to retain a degree of dignity and privacy runs against the media age in which we live, where most details about public officials are well known.

Over the past 15 years, the Queen and her officials have gradually and carefully reduced her public schedule so that it was more manageable given her age without much notice.  This was to conserve the Queen’s stamina and to avoid last-minute cancellations, which give rise to public concern and uneasiness. The Queen also does not wish to disappoint people who have made plans and only does so when she must.

For someone who has been on the job for near 70 years, the Queen has only rarely been hospitalized or had to forgo a commitment due to illness. The removal of a wisdom tooth (1982), a broken wrist (1994), the replacement of cartilage in her knee (2003), and a bout of gastroenteritis (2013) have been among the few occasions on which the public has been informed of any issues with the Queen’s health.

The women in her family, including her mother, her grandmother, and great grandmothers, like Queen Victoria, all lived healthily to a ripe old age, given the times. There is no evidence that Elizabeth the Second will not follow them, but at age 95 and after a bruising couple of years dealing with the pandemic, a son and grandson who are causing difficulties, as well as the loss of her husband, it has clearly taken a toll. In October and since, the Queen has appeared to be in good form, albeit looking a little thinner and frailer than we remembered her in pre-pandemic times.

The last 18 months forced the Queen to be at home with little on her schedule for the first time in her life. She no doubt wanted to throw herself back into activities this fall. A full calendar of twenty-five engagements was planned in October until the last few were curtailed due to doctor’s orders.

The Palace had earlier announced that the Queen would be unable to attend the General Synod of the Church of England later this week. This will be the first time in her reign that she would not attend this given the importance of her role as Supreme Governor of the Church. There are now few public engagements forecast for the balance of the year. It is likely that the next time the public will see the Queen is during virtual audiences for diplomats or other activities that she can undertake from her desk at Windsor Castle. Many will be looking forward to her annual Christmas message, which will be released on Dec. 25.

The Palace has made clear that Her Majesty will continue to be able to fully perform her constitutional duties such as approving Privy Council orders, granting Royal assent to bills, receiving the Prime Minister and diplomats, and keeping abreast of political and foreign developments. There are constitutional arrangements in place for Counsellors of State (presently only the Prince of Wales and Prince William) to perform these duties if necessary, or in a more serious case of poor health, a Regency could be declared. For Canada and other realms, the Governor General has all the authority needed to act for the Crown.

It may well be that we are beyond the level of visibility we have come to know and expect from the monarch and discretionary public engagements may no longer be possible. But that will not sit well with the Queen herself, who has said she ‘needs to be seen to be believed.”  It is also difficult for the public to accept that this constant and iconic steady force is not as present in the public life of the Commonwealth, at a time when there are few other symbols of stability and continuity in rapidly changing and troubling times. The focus is shifting to the next generations.

Today it seemed like “God Save The Queen” was sung a bit louder and purposefully at the end of the ceremony - as it was at the Festival of Remembrance last night, along with the customary three cheers for Her Majesty. Many of her subjects and those throughout the Commonwealth will be joining in the line “Long to Reign Over Us” and the hope for a return to better health for the Queen in the weeks ahead.