Is Compass about to call for tactical voting on the liberal left?

The search for a new, non-tribal politics continues.

The influential left-wing pressure group Compass -- launched in 2003, chaired by Neal Lawson and fronted by Labour's Jon Cruddas -- has sent out an email tonight to its 4,000 members asking them whether or not the organisation should devise a short statement in support of tactical voting to help stop the Tories from winning the general election.

A ballot form is attached to the email, which says:

something seismic could be happening in British politics which reflects the Compass view of a more pluralistic and tolerant progressive democracy . . . So should Compass actively promote this new politics by arguing for tactical voting -- and calling on people to back the best placed progressive candidate to stop the Conservative candidate and deprive the Conservatives of victory at the general election?

Endorsing tactical voting, naturally, means endorsing Liberal Democrat candidates in Tory-Lib Dem marginals -- something that Labour pluralists like Alan Johnson and Andrew Adonis have so far refused to do. To be fair, the letter acknowledges that such a move by the organisation could be controversial, noting that "while Compass is not affiliated to the Labour Party many Compass members are also members and supporters of Labour".

Compass has been attacked in the past by Labour tribalists for daring to reach out across party-political lines, inviting non-Labour figures such as the Green Party leader, Caroline Lucas, to its conferences. So I imagine the likes of Luke Akehurst won't be too pleased tonight.

I'm not a member of Compass, but if I was, I'd be backing the move. Why? 1) Progressive coalitions are a good thing. 2) Labour tribalists are short-sighted and self-destructive. And 3) Lib-Lab tactical voting might be the only means left of denying the Tories victory on 6 May and preventing a disastrous Cameron premiership.

Mehdi Hasan is a contributing writer for the New Statesman and the co-author of Ed: The Milibands and the Making of a Labour Leader. He was the New Statesman's senior editor (politics) from 2009-12.

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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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