New doubts over the health of North Korea’s “Dear Leader” have arisen after Kim Jong Il’s eldest son was filmed in Paris apparently soliciting the services of a top brain surgeon.

The footage, shot by the Japanese Fuji Television, has rekindled conjecture that Mr Kim is gravely ill and has possibly had a stroke. Speculation over the enigmatic dictator’s health has been rife, with some North Korean defectors suggesting that Mr Kim is at death’s door.

That speculation has led some intelligence experts to suggest that Pyongyang may, behind the scenes, be in the grip of a struggle for supremacy by opposing factions eager to take over when the 66-year-old dictator finally loses his stranglehold on power.

Concern about Mr Kim’s health mounted after he failed to appear at a key anniversary parade in early September, an event to which the domestic North Korean propaganda machine had been building throughout the year.

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Although few things can ever be said for certain about North Korea’s internal affairs, experts said the evidence that Mr Kim is seriously ill is now overwhelming. Brian Myers, an authority on Pyongyang propaganda at Dongseo University in South Korea, said that his absences could no longer be dismissed as another facet of his traditional unpredictability.

The footage shows a man, identified by North Korea watchers as “undoubtedly” Kim Jong Nam, entering a Parisian clinic for a discussion. Two days later, an unnamed French doctor was filmed arriving at Charles de Gaulle airport in a car owned by the North Korean mission to Unesco. When asked, the doctor did not deny that his destination was Pyongyang.

If the doctor does fly to Pyongyang to administer treatment or advice to Mr Kim, he will not be in breach of any sanctions against North Korea. France does not object to individuals travelling there provided it is a private initiative. Although France does not have an embassy in Pyongyang, several other European nations do maintain diplomatic relations with the state, including Britain.

The footage of Kim Jong Nam has triggered speculation over the thorny issue of family succession in the world’s only Stalinist dynasty.

Kim Jong Nam had previously been written off by North Korea observers as an unlikely successor to his father. He has previously shown little interest in navigating the complex power elite that governs the hermit nation, preferring to concentrate on his business affairs in Europe and Asia.

He has also set his prospects back with a series of diplomatic blunders. He was very publicly expelled from Japan in 2001 after entering on a fake Dominican Republic passport and saying that he wanted to go to Tokyo Disneyland. Kim Jong Nam is the son of Kim Jong Il and the well-known actress Sung Hae Rim, according to cousins who defected to the West.

North Korea has condemned reports that their leader has health problems as a “whopping lie”, and last week denounced Japanese newspapers for reporting that North Korea was on the brink of a major announcement. The Japanese press reported that members of North Korea’s military and political elite had been told to cancel their plans in anticipation of a major revelation – thought by some to be a pronouncement on the Dear Leader’s state of wellbeing.

In a move viewed by some analysts as a further possible sign of instability within the regime, Pyongyang last week proposed to South Korea that the two countries hold talks on how to improve military hotlines that are viewed as one of the few conduits through which any escalation of violence along the border could be calmed down in a hurry.

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