Clegg shows how the coalition will attack Labour in 2013

The coalition will challenge Labour to say which cuts it would keep and which it would reject, but it shouldn't expect any answers.

Nick Clegg's article in today's Times (£) offers a preview of an attack the coalition will use repeatedly against Labour in 2013: what would you do? In reference to Labour's opposition to the coalition's plan to increase benefits by just 1 per cent for the next three years, Clegg writes: "Labour must show how they’d pay for it. Would they cut hospital budgets? Schools? Defence?" He also demands that Ed Balls and Ed Miliband say which of the coalition's cuts "they would keep, which they would lose and where they would find the money instead."

But the Deputy PM shouldn't expect answers any time soon. In an end-of-year interview with the Times, Ed Balls signalled that Labour would hold back its key tax and spending commitments until 2015. "Until we know the state of the economy, the state of the public finances and how bad things have turned out, it’s very hard for us to know what we can possibly say."

Balls's argument is a reasonable one. The Office for Budget Responsibility originally expected the economy to grow by 5.7 per cent between the first quarter of 2010 and the second quarter of 2012. It actually grew by 0.9 per cent. As a result, the coalition is now forecast to borrow £212bn more than planned in June 2010. In view of this record, it would be unwise for Labour to make any hard and fast commitments until the latest moment possible. Balls has gone as far as banning shadow cabinet ministers from saying which cuts they would keep for fear of creating the impression that Labour will be able to reverse all of the others.

But with a Spending Review due to be held later this year, the coalition will begin to challenge Labour to say whether it would match its post-election spending plans, as it did with the Conservatives' in 1997. With little fanfare, the Liberal Democrats have accepted George Osborne's fiscal envelope (which now extends to 2018), if not all of his proposed cuts. For instance, while Clegg successfully rejected Osborne's bid to secure £10bn of additional welfare cuts, limiting the Chancellor to £3.8bn, he did not question the assumption that £10bn of further austerity was necessary, merely that all the savings needed to come from welfare. Whether or not Labour should adopt the same approach is the biggest decision Balls and Miliband will make before the election. A pledge to match the Tories' spending limits would insulate Labour from the charge that it is planning a tax or borrowing "bombshell" but it would enrage the left and the trade unions. I'll have more on this in my column in tomorrow's magazine.

Nick Clegg delivers a speech to the think-tank Centre Forum at The Commonwealth Club on December 17, 2012 in London. 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