How seven years of cuts will transform the political landscape

The notion that a Labour government in 2015 would itself be a cutting government has yet to sink in.

When it comes to big political set pieces, like yesterday's Autumn Statement, the predictable somehow still manages to surprise. Everyone knew it would be bad; and we all knew it would raise big challenges for all three parties. Yet today, everyone is caught off-guard.

In part, it's because the unprecedented duration of the cuts -- until 2017 -- is now abundantly clear and longer than many had appreciated. Think back to 2004, when the economy was booming; a rising star of the Conservative Party, David Cameron, had risen to the lofty position of opposition spokesperson on local government; Nick Clegg had just stepped down from the European Parliament; and a young Treasury advisor by the name of Ed Miliband had just returned from a sabbatical at Harvard. Seven years really is a very long time in politics. That's how long we're going to be talking about cuts for, so we'd better get used to it. We also know that the pain on public sector pay will extend to 2015 (and probably longer). Household living standards won't start to tick up until at least 2014. The wages of the typical worker are unlikely to surpass their pre-recession levels until at least 2020. The roll call of long-term economic misery goes on and on.

Which is why all parties woke up today still trying to come to terms with what it all means for their central political purpose and pitch. For the Conservatives, who currently have a clearer account of how to traverse this new terrain than any other party, it is the final confirmation, if any were needed, that they are ditching their previous modernisation strategy. Turn the clock back just a few years and think about the core elements of Cameron's one-nation argument -- a strategy which was clear, politically potent, and created the space for the formation of the coalition. Demonstrate progressive credentials via a new Tory commitment to child poverty that was supposed to warm the heart of the likes of Polly Toynbee. Create a new base of political support within the public sector. Make headway in the north of England. Reach out to new and younger voters through a "vote blue, go green" message. Convert the Conservative party into a 21st century home for hard-pressed working women. Most of these claims are now in shreds; all are severely tarnished. In their place is a very big bet that they can win on economic leadership in tough times -- a bet that may still prove right -- but one that leaves the modernisation agenda as a relic of a bygone era.

For the Liberal Democrats, perhaps more than any other party, yesterday may turn out to be seismic. It will certainly be viewed by many of their members as the moment when a bunch of Treasury civil servants, together with Danny Alexander, blew a hole in their next manifesto. The central proposition of the coalition -- coming together in the national interest to tackle the deficit within the life of the current parliament -- is no more. Now the time-span of the shared central commitment to cuts has been cast forward into the latter part of the decade. And the Liberal Democrat leadership has pledged the coalition will undertake a spending review itemising cuts beyond the next election -- presumably cuts that will therefore have to figure in both the Liberal Democrat and Conservative manifestos (so much for the much heralded "differentiation" strategy). And all this without a trace of internal party discussion -- unless, that is, someone is going to tell us that Simon Hughes and Tim Farron happened to be sitting in on the Treasury's forecasting meetings. All of which poses a few questions: the balance between tax-rises and spending reductions? The political viability of seven years of austerity for an already weakened party, many of whose members self-identify as being on the centre left? But no need to debate these trifling issues, or so it seems.

And the implications are barely less far-reaching for Labour. Above all, the worse the economic news, the higher the stakes become -- and the louder the ticking of the clock as people wait for the party's polling numbers on economic competence to turn upwards. If that doesn't start to happen soon, more and more people will wonder quite what George Osborne would have to announce about the dire state of the economy before Labour starts to take a lead on these issues.

Last week in a speech Ed Miliband rightly struck a slightly different and more accommodating tone, seeking to persuade a largely unconvinced public that his party's economic argument was right for our times. He also went out of his way to stress that if elected he will embrace the challenge of governing under austerity, though in a different way to the coalition. That sentiment is now either going to be reversed (if the leadership decides it can't stomach the gritty reality of talking about cuts in the next parliament, which would raise huge questions about Labour's fiscal credibility) or, far more likely, it will have to become mainstreamed and echoed right across the party. And that means entering the day-to-day politics and vernacular of every shadow cabinet member. The notion that a Labour government in 2015, inheriting a greatly diminished public sector, will itself be a cutting government is yet to sink in. To put it mildly, it is quite a mind shift.

Make no mistake: even though yesterday sort of went as predicted, it also changed everything.

Gavin Kelly is a former adviser to Downing Street and the Treasury. He tweets @GavinJKelly1.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear