What does Miliband mean by the "structural" welfare bill?

It doesn't even need capping.

Ed Miliband will cap "structural welfare spending" if he is elected in 2015, he announced today, saying that "such a cap will alert the next Labour government to problems coming down the track and ensure that we make policy to keep the social security budget in limits."

It's not entirely clear what Miliband means by "structural" welfare spending at this point. It could just be a political fudge, designed to mimic the Conservatives' similarly fudgy focus on the "structural" deficit. The structural deficit is a particularly difficult thing to actually measure, because it relies on three pieces of information all of which are themselves uncertain: the output gap, the relation of public spending to economic growth, and the response of tax revenues to both.

Get any of them wrong, and your estimate of the structural deficit is off; get all three wrong, and you can be billions of pounds off the mark. And look at just the variation in the estimates of the output gap, via Touchstone:

But whereas the structural deficit is at least a conventional economic concept, albeit one hugely prone to measurement error, it's not entirely clear what "structural" welfare spending is, and even less clear how to cap it.

The best guess is that the structural welfare bill is the bill which we would expect to see in normal times; in other words, Labour won't view a rise in housing benefit due to the recession as a problem, but would be more concerned if, during the recovery, it fails to drop down to lower levels.

If that is the definition, then it has an interesting outcome once Labour start to cap it, because, as Declan Gaffney showed last month, "there has been no structural increase in the level of aggregate working age welfare spending for a very long time". That's because welfare spending, properly construed, must take into account foregone revenue as well as public expenditure: the most prominent example of which is tax credits. Around £3bn of the cost of tax credits in 2012/13 came from an offset to income tax. Money wasn't being "spent", but it was certainly a cost of welfare.

And when you take into account other taxation expenditures – like the mortgage interest tax relief, which was abolished in 2000 – you find that structural welfare costs have stayed remarkably stable. This chart again from Declan Gaffney's piece:

 

The real question is what "structural" welfare means for people not of working age. Because, thanks to our ageing nation, the state pension liability is growing year-on-year, and even pushing back the pension age by a year from 2026 won't help too much. Of course, it would be possible for Labour to define that increase as something other than structural – "demographic", perhaps – and thereby dodge the question. But if they don't, the key effect of this promise could be that Labour has pledged to cut pensions, two years before a general election against a party which has pledged to keep them above inflation and wage rises indefinitely.

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

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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