Yet again, the budget pushes the North a little further from the South

It's two nation Britain.

With growth forecasts halved to 0.6 per cent this year, and unemployment rising again in the north of England, this needed to be a budget for growth across the UK. Instead, the headline measures will do more to further inflate house prices and childcare costs in London and very little to boost regional economic opportunities. Meanwhile, further public spending cuts – not least in pay and benefits - will have a continued deflationary impact on many Northern towns and cities.

The budget has come on a day when unemployment figures show the North-South divide widening further – up by 10,000 people across the north of England in the past quarter compared with a 17,000 fall in London.

Measures such as the increase in the income tax threshold and the National Insurance allowance for small businesses will be welcomed by many but won’t have the effect of rebalancing the economy – rather, they will tend to benefit those areas where wages are higher and the business base is broader.

More significantly, measures to increase new house building are to be welcomed but there is a significant risk that making it easier for borrowers will simply prop up prices – indeed, inflate prices – rather than getting additional homes built. It is not clear that Help to Buy will generate additional new housing starts, beyond what would have been undertaken anyway (which will certainly not be the case for mortgage subsidies that are not linked to new-build) and the 15,000 new homes promised in the budget go nowhere near most estimates which suggest we need to build an extra 250,000 new homes a year to meet rising demand. Similarly, childcare changes will soon be wiped out as providers inflate costs with little additional provision.

Of those measures that will stimulate growth it is too little too late. It is encouraging news that the Chancellor has broadly endorsed the Heseltine report but with government sources suggesting that resources going into the "single pot" will be in the “lower billions” rather than the £49 billion Heseltine recommended – and even then not until April 2015 – this will hardly be a short-term stimulus.

The £3bn boost in infrastructure spending is something that IPPR North and many others have been calling for many months but will do little to help us catch the levels of capital investment spent in other nations and once again won’t land until 2015/16. Furthermore, we cannot hope this will boost regional growth when we currently plan to spend £2,595 per person on transport in London compared to just £115 per person in the north. Transport spending must be devolved more fairly to have a real impact.

With much evidence pointing towards the critical role regional economic development is playing in stimulating national economies across the developed world, this budget – however populist – will do little to restore the economic health of the nation and will ultimately be regarded as a missed opportunity.

But perhaps the bigger tragedy than this missed opportunity is the fact that regional prosperity hangs so much on central government decision-making at all. With greater fiscal decentralisation economic growth could be better tailored to the particular needs of local and regional economies and less dependent upon the big levers so clumsily wielded by chancellor after chancellor. Such reform is long overdue.  

Photograph: Getty Images

Ed Cox is Director at IPPR North. He tweets @edcox_ippr.

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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