PMQs review: Cameron flounders

Miliband has so far set the agenda on News International. A visibly flustered Cameron did little to

The accepted wisdom this week has been that the phone hacking crisis has allowed Ed Miliband to find his voice as leader of the opposition, and this was confirmed at today's PMQs.

Miliband was calm and confident, while David Cameron looked increasingly harried and flustered.

Miliband opened by asking whether Rebekah Brooks should resign -- an awkward point for Cameron given his well-documented personal friendship with her. His response was that she was "right to resign" and that this should have been accepted (according to some reports, she offered to resign). A huge positive for Miliband in this matter is that he is relatively "clean" when it comes to social relationships with the Murdoch clan - much more so than his brother, David, who is close to Elisabeth Murdoch and her husband Matthew Freud.

A second significant weak point for Cameron - and one that was raised repeatedly - is "the catastrophic error of judgement" he made in hiring Andy Coulson. Cameron repeated his defence that in this country you are "innocent until proven guilty". He added that he hired Coulson on the basis of assurances that he had not broken the law -- the same assurances made to police and a select committee. "If these assurances turn out not to be true then it's not just that he shouldn't have worked in government, but that he should face the full force of the law."

His discomfort on the issue was evident in his snarky response to Labour MP Rushanara Ali: "As I said before she wrote her question, or had it written..." As ever, Cameron falls back on nastiness when he is floundering.

Cameron's decision not to appear at this afternoon's debate on phone-hacking has also weakened his position. He indicated to Miliband last night that he would reply in person to the Labour leader - which in itself shows how nervous No 10 is that Cameron be left behind on the issue, as it is unusual for a Prime Minister to reply to an opposition day motion.

The fact that he will now not be present for the debate (Sir George Young, the Leader of the House, will respond in his place) gave Miliband some easy shots. "I look forward to debating this with the Leader of the House," he said. Cameron's only response was: "I think we should focus on the substance."

In moving early this weekend to condemn Rupert Murdoch and call for the BSkyB bid to be dropped, Miliband set the agenda, and Cameron knows it. He did little to gain back that lead today.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for 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