The fate of Lords reform now rests in Labour's hands

With the Tories irretrievably divided, the bill's future depends on Labour.

As was rumoured this morning, David Cameron has now dropped the programme motion on House of Lords reform, which would have limited debate on the bill to 10 days. With upwards of 70 Tories prepared to join Labour and vote against the motion, there was no hope of it making it past the Commons. In withdrawing the motion, Cameron has merely brought forward the government's defeat.

The second reading vote will still go ahead and, with the support of Labour, the bill will proceed with a large majority. But unless the government introduces a guillotine motion at a later date, the risk remains that MPs will talk it into the ground.

The upshot is that the fate of Lords reform now rests in Labour's hands. If Ed Miliband's party agrees to support closure motions to limit debate on the bill, the legislation could yet make it through the Commons. Responding to Cameron's move, Sadiq Khan has pledged that Labour will do all it can "to ensure the bill progresses". The party's opposition to the programme motion was not, he said, a "wrecking tactic" but an attempt to improve an "inadequate bill".

As Khan's words imply, Cameron and Nick Clegg will need to offer concessions in order to win his party's support. The most obvious would be a referendum on Lords reform, as proposed by Labour in its 2010 manifesto. This would have the added benefit of placating at least some of the Conservative rebels, such as Nadhim Zahawi and Rory Stewart, who have said they would be prepared to support the bill were a public vote promised. Others, flushed with success after the AV campaign, simply want the chance to give Clegg another bloody nose. (We must hope the voters decide otherwise.)

The Lib Dem leader has always resisted a referendum on the grounds that all three of the main parties supported reform in their manifestos. But with parliament divided, he will find it hard to argue that the people should not be given a say. Tonight, a referendum looks like the only way to avoid yet another defeat for reform.

Labour leader Ed Miliband has called for a referendum on Lords reform. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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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