Indeed the richness of his work proves how right Kipling was when he pondered, "Who knows England who only England knows?" Doctors often make observant writers and Dalrymple has practised medicine in places as exotic as the Gilbert Islands in the Western Pacific. Soon after qualifying as a physician, Dalrymple went out to work in Rhodesia, and spent much of the next decade in Africa. The politically-correct types who have reflexively labelled him a bigot would be shocked by his respect for Africans and unillusioned depiction of the last years of colonial rule. Back in the UK, he chose to work in deprived areas when he could have catered to the afflictions of the affluent. Reporting assignments took him to perilous places like Peru during the worst of the Shining Path uprising where teenaged cadres disembowelled government officials: "As a doctor I am accustomed to unpleasant sights," he wrote with typical restraint, "but nothing prepared me for what I saw in Ayacucho."

It is telling that much of Dalrymple's best writing about England was published first in America, mostly in City Journal, the Manhattan Institute's quarterly magazine. In a column entitled "Oh To Be In England", Dalrymple writes much longer essays than he had in the Spectator. They take readers deep into the British underclass.

It is a world of self-pitying but otherwise pitiless prisoners, masochistic nurses defending the partners who beat them, children left adrift by parents and the state, and whole groups whose rights are trampled thanks to a cynical officialdom steeped in political correctness. For years Dalrymple was the only voice to raise the issue of the disappearance from school of thousands of girls from Muslim families once they reach marriageable age — and the subsequent kidnappings, forced marriages and rape to which they are often subjected. 

Though Dalrymple had published  books on travel and medicine, his superb, indeed essential, articles on the underside of British life went ignored in the UK. Mainstream publishers, it seemed, were too narrow-minded, conformist or cowardly to deal with such material. It was the US publisher Ivan R. Dee who collected them in Life at the Bottom and Our Culture, What's Left of It. Dalrymple has now written some 40 books, the latest of which is Litter.

He is understandably loathed by lockstep-liberals and what he calls "the bureaucratic caste", but those in charge of Britain's agenda-setting TV and radio programmes would do well to listen to him. Theodore Dalrymple brings to his arguments a combination of philosophical sophistication, genuine humanity and real-world experience that is unique.