Moving the goal posts won't hide the coalition's failure on child poverty

Iain Duncan Smith's plan to change the way child poverty is measured is a distraction.

The consultation on child poverty measurement announced by Iain Duncan Smith today is generating exasperated groans from those who have been engaged with the subject for decades.

It is not as if we haven’t been here before. The last extensive consultation ended in 2003 but the indicators have continued to be refined since then. The portfolio of measures that eventually became the targets in the Child Poverty Act 2010 were developed through a discussion between government and social scientists over many decades after the publication of Abel Smith and Townsend’s "rediscovery of poverty" book The Poor and the Poorest in 1965.

And the measures we now have are very good, arguably the best of any country in the world.  They encompass understandings of poverty as relative, absolute (actually constant), deprivation, overlaps of income and deprivation, and persistence. They have been adopted by international organisations such as the EU, OECD and UNICEF, and copied by other governments. Of course they are not perfect. It would be good to add an indicator of how deep poverty is (poverty gap). But do we really need a consultation to add new measures?

Without any fuss the government have already added a new severe measure of poverty – less than 50 per cent of the median and materially deprived – following the Frank Field review. The Child Poverty Strategy published in 2011 proposed a sensible list of ten indicators (additional to the five Child Poverty Act indicators) that they would use to monitor progress. Or the government could go further and revert to the list of 24 child indicators that DWP published in the Opportunity for All series between 1999 and 2007 covering poverty, health, education, housing and child protection.

There is no dearth of indicators; what we lack are policies that will continue to drive the figures downwards after a decade when 1.1 million children were lifted out of poverty. Instead, we have a consultation that is seeking to develop a "multidimensional indicator" of child poverty, relegating income – and especially the relative income measure – in the process.

Some people have never liked the relative poverty measure because it is a measure of inequality. Before Iain Duncan Smith, Conservative social security secretary John Moore, attempted to do away with it in the 1980s. Ministers now try to ridicule the relative measure because it showed a fall in child poverty in 2010-11, partly driven by a fall in median income. But that is why we have a portfolio of measures.

It is a national tragedy that after a decade of progress that has seen child poverty and child well-being improving, from a pretty low base, the coalition’s policies have sent it into reverse. Moving, adding or blending the goal posts will not hide this fact.

Jonathan Bradshaw is a Professor of Social Policy at the University of York and a trustee of the Child Poverty Action Group

Work and Pensions Secretary Iain Duncan Smith speaks at last month's Conservative conference in Birmingham. Photograph: Getty Images.
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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