Adonis's review should galvanise the North East and its neighbours

While the coalition dithers on its growth strategy, the Labour peer has set out precisely the rebalancing the nation needs to recover from the crash.

The launch of the North East Independent Economic Review, chaired by Andrew Adonis, provides further evidence that while the government dithers on economic growth strategy, others are prepared to set out their stalls. First Heseltine, then the Northern Economic Futures Commission and now Adonis all point to the importance of local and regional economies in returning the nation to prosperity.

Adonis sets out a North East vision comprised of "making, trading and exporting" – precisely the rebalancing the nation needs to recover from an economic shock which started in the financial sector but which has had its greatest impact in the north. It calls for the creation of 60,000 private sector jobs and makes clear that the north east has some key competitive advantages to enable that rebalancing and job creation to happen if only opportunities can be unlocked.

The review makes proposals to boost exports and supply chains and co-ordinate inward investment activities through the formation of North East International, it calls for a North East Innovation Board to oversee the development of key innovation centres in life sciences, automotive manufacture and offshore engineering, and it makes the case for a regional business bank and a successor body for the NE JEREMIE, European and social enterprise funds overseen by a NE Investment and Finance Board. In many ways this puts back together again some of the functions that were once carried out by the regional development agency but with a fresh purpose and momentum.

Skills, widely accepted to be critical to driving growth in regions like the North East, also have a key role in the plan with proposals for a North East Schools Challenge, a doubling of the numbers of youth apprenticeships, increasing number of young people in higher education by 1 per cent per annum and a payment-by-results component for local training providers. It also calls for a strategic plan for transport and a NE Infrastructure Fund to fund a series of key priorities including smartcard ticketing, the A1 Western Bypass and A19 developments, and a series of rail improvements including to maximise freight potential. These should be led by a new body: Transport North East.

All of the proposals are sensible and progressive and emphasise what the North East can do for itself if it can now get its act together, establish the Combined Authority it has recently announced, and come up with a delivery plan that turns aspiration into action. Three questions, though, remain.

First, there is the matter of scale. While many measures make sense at the North East level and require the kind of co-ordination that Adonis has proposed, there are a few where the North East will have to work more collaboratively beyond its borders to maximise its potential. On inward investment, innovation and transport in particular, North Eastern activities need to be quickly integrated with activity taking place in Tees Valley but perhaps, more importantly, with other Northern LEPs. For example, Transport North East will only be able to achieve its objectives of faster journey times between key cities if it quickly gets behind plans to decentralise the Northern Rail and Transpennine franchises being organised by the emergent 'Transport for the North' collaboration.

Second, there is central government. Adonis is right not to be too demanding and let Heseltine do the heavy-lifting in this regard, but in most aspects of the review, some central government leniency will be required to allow proposals the freedom – and investment – to really take off. Changes to the national FDI system, University Technical Colleges, locating the British Investment bank in the North East would all be cases in point but long term fiscal autonomy and much greater economic decentralisation must be the wider goals for all Northern LEPs and these will only be achieved with a wider Northern voice.

Finally, there is the question of time. With the Financial Times reporting that places such as Sunderland will be £618 per person worse off than before as a result of welfare changes, one wonders whether any plan of this nature can offset such a hit to the local economy. Clearly there is a very real sense that things can only get worse before they get better, but Adonis and his review team have put together a coherent plan and for now it’s the only game in town.

Ed Cox is director of IPPR North

@edcox_ippr

Labour peer and former transport secretary Andrew Adonis.

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