Cameron is complacent about the Tory right flank

Internal opposition is not restricted to "one or two backwoodsmen".

The key moment in Michael Gove's interview with Andrew Marr this morning came when he was challenged on the growing opposition from the right of the Tory party to the Cameron project. He replied:

When you carry out any kind of modernisation there are always one or two backwoodsmen who will grumble in the undergrowth.

In fact, the evidence suggests that a far greater number of MPs and activists remain highly sceptical of David Cameron's modernising agenda. There are two critical divisions: the first over policy and the second over party structure. The main tensions in the first category are over climate change and Europe.

On climate change, which ConservativeHome's Tim Montgomerie has predicted will prove as divisive for the party as Europe was in the 1990s, we have seen that reducing Britain's carbon footprint is the lowest priority for Tory candidates. As Montgomerie points out: "You have got 80 per cent or 90 per cent of the party just not signed up to this. No one minded at the beginning, but people are starting to realise it could be quite expensive, so opinion is hardening."

On Europe, although Cameron would most likely be the most Eurosceptic prime minister in history, many activists and backbenchers remain angered by his refusal to promise a referendum on any aspect of Britain's EU membership. Unless he manages to repatriate significant powers from Brussels (which is unlikely), we can expect this issue to flare up again.

Tory modernisers are fond of reminding us that significant sections of the Labour Party never accepted Tony Blair's policy agenda. Yet there is a big difference. Following the repeal of Clause Four, there was no serious constituency of support for wholesale nationalisation. But in the case of today's Tories, the right-wing dominance of the press means that Euroscepticism and and climate-change denialism have not been similarly discredited.

Meanwhile, the Joanne Cash affair demonstrates how hostile many local activists are towards what they see as Cameron's centralisation of the party. That the debacle took place in Westminster North (not usually Turnip Taliban territory) makes one wonder how much anger there is elsewhere in the country.

It is increasingly likely that Cameron will be forced either to swerve to the right or to lead a divided and resentful party. These are equally unpalatable options for a modernising leader.

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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