Miliband should sack Ed Balls

Labour cannot hope to rebuild its economic credibility while Balls remains shadow chancellor.

In his upcoming reshuffle, Ed Miliband should replace Ed Balls as shadow chancellor.

The Labour party is currently becalmed, and with it Miliband's leadership. In the 12 months since he replaced Gordon Brown, Labour's poll rating has risen one per cent according to the most recent Populous poll, two points according to MORI. Despite riots, war and economic stagnation Labour's leader cannot break beyond the margin of error.

Those wondering whether phone hacking would be a game changer have their answer. It has changed nothing. Despite his deft response to the crisis almost half of Labour supporters cannot picture Ed Miliband as prime minister, and his general approval ratings are plumbing new depths.

But it's not only Ed Miliband the polling furies have chosen to mock. Unemployment is rising. Business confidence declining. Growth estimates are being frantically revised down. Yet unbelievably, the Conservative party has now opened up a ten point lead over Labour on the issue of who has the best economic policies for the country. Even more staggering, their lead has actually increased since March. The worst things get for the economy, the better things seem to get for George Osborne and his party.

There is a simple reason for this paradox. Labour's own economic policy has no clothes. The deficit is the defining issue in British politics. And Tory attempts to brand Labour as deficit deniers have succeeded beyond their wildest dreams. In fact, they have not so much branded shadow ministers as embalmed them, placed them in a glass case and erected a sign "Deficit Denier, official exhibit, 2010 - present".

No one within the Labour party is prepared to even glance at, never mind acknowledge, this elephant in the shadow cabinet room. Nor are they prepared to acknowledge the even larger elephant balancing upon its shoulders. The person who must take responsibility for this parlous state of affairs is Ed Balls.

Labour's shadow chancellor is one of the few political heavyweights on the front bench. But in this specific brief he is an albatross around his party's neck. All the opinion polls indicate the public blames the economic policies of the previous Labour government for the cuts to thier services, along with the hardship they are experiencing, more than the coalition. And Ed Balls is the individual in the shadow cabinet more closely associated with those policies than any other.

Ed Miliband is acutely aware of the toxic legacy of the Brown premiership. Hence his reluctance to even raise the issue of the economy in the wake of the publication of the Darling memoirs. But if he is wary of discussing economics when David Cameron has a copy of Back from the Brinksitting on his lap, how can he hope to make a case whilst he has Ed Balls sitting on his own?

Nor is this just an issue of legacy. Ed Balls was instrumental in rebuilding Labour's economic credibility from the rubble of the 1992 election defeat. He did it by adhering to a simple golden rule. If Labour couldn't ditch their tax and spend image they were unelectable. Prudence became the watch word. Shadow ministers were banned form making any commitments on spending. Gordon Brown, at Ball's urging, pledged to stick to Tory spending limits, and did so even after Labour's landslide 1997 election victory.

Yet as shadow chancellor Ed Balls seems intent on unlearning every rule he once imposed with iron, and occasionally brutal, discipline on others. Labour's policy has not just regressed to tax and spend. It's now cut tax and spend. New expenditure commitments are tossed around like confetti. Tax cuts bounced out with no internal consultation. Prudence has been ditched, replaced by that leather clad vixen, Ms Pump Primer.

What is Ed Balls thinking? It's not just that he's trying to get the voters to embrace an economic agenda they rejected decisively at the 2010 election. They're being asked to endorse economic policies they rejected at the 1979 election. The perception of fiscal profligacy isn't a dead end for the Labour party. It's political hemlock. We know this because Ed Balls told us it was. And he was right.

Labour's economic policy is no longer grounded in political reality, but in a combination of misguided loyalty, stubbornness and Keynesian economic orthodoxy. Ed Balls seems to believe distancing himself from the policies of Gordon Brown would represent a form of betrayal. It would not. It's just the price of doing business for a new party of opposition. He also seems to equate dogma with strength. Yet by sticking unflinchingly to the failed strategy of a failed manifesto he is reinforcing every negative stereotype his enemies have ever sought to construct around him. "The reckless thing to do is plough on regardless", he told Tribune this week. Too right.

Ed Balls is shadow chancellor. His is not chancellor. His prescriptions for the nation's ills may be economically sound. But they are politically unsustainable. Saying 'I was right, you were wrong' to your political opponents, is one thing. Saying it to the voters is a different matter entirely.

He seems unable, or unwilling, to acknowledge this. A destructive combination of loyalty, stubbornness and pride have locked him into a strategy from which he cannot escape. Which is why, at the next shadow cabinet reshuffle, Ed Miliband needs to set Ed Balls and his party free.

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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