The Tories' cost of living offensive starts with a whimper

The pledge to cap rail fare increases at 6% is unlikely to impress commuters who have suffered 11 years of above-inflation rises.

At the Conservative conference last week, both David Cameron and George Osborne used their speeches to deride Ed Miliband's focus on the "cost-of-living crisis" on the grounds that it was a distraction from the primary task of 'fixing' the economy. But while doing so, the Tories have also recognised that the Labour leader is onto something. 

The day after Cameron's speech it was briefed that the party would soon launch a "blitz" on the cost of living and that Osborne had "identified water bills, rail fares and bank fees as areas where the government can act to help with household bills." After previously dismissing Miliband's proposed energy price freeze as "a gimmick", Cameron notably acknowledged on ITV's The Agenda that the Labour leader had "struck a chord" with the public. 

With real incomes not expected to rise until 2015 and not expected to return to their pre-crash levels until 2023, Tory MPs are rightly warning their leadership not to dismiss the living standards crisis as a temporary ailment that will pass now growth has returned. A recent ComRes survey found that voters think the Tories are more likely to maintain economic growth (42-33%) and to keep public spending under control (47-28%), but also that they believe their own family would be better off under Labour (41-31%). If one party takes a decisive advantage before 2015, it is likely to be that which wins the trust of the public on both issues.

The Tory fightback has begun today with the announcement that rail fare increases will be capped at 6%, with companies barred from raising individual fares by more than 2% above RPI inflation, rather than the current limit of 5% (provided that the average rise is 1% above inflation). Ministers say that the move could save commuters around £20 a month but with fares still set to rise above inflation for the eleventh year in a row (while average earnings fall for the sixth year in a row), it's rather small beer. Labour has been able to hit back by pointing out that the move doesn't go as far as its pledge to limit all fare increases to 1% above inflation and former transport secretary Andrew Adonis has noted that the cap is "less tight" than the one he imposed in 2009-10. 

The Tories are promising "week by week" announcements in the run-up to the Autumn Statement but they'll need to do better than this to wrest the initiative back from Miliband.

David Cameron leaves Number 10 Downing Street on October 7, 2013. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Testing migrant children’s teeth for their age is not only immoral – it doesn’t work

Ministers have flirted with this idea for over a decade. It’s bad policy, as well as poor ethics.

This week, the Home Office finally ruled out the use of x-rays to establish the age of childhood migrants.

It’s welcome news, but this story predates the dispersal of the Calais “Jungle” camp. 

For over ten years, ministers in Conservative and Labour governments have flirted with these tests. And it’s been up to us – the practitioners who’d be expected to administer them – to pick holes in a policy that’s a great way of securing headlines, but simply cannot deliver on the claims made by its cheerleaders.

It goes without saying dentists are health professionals, not border guards. But our objections run deeper than that. And it’s worth revisiting the arguments, just in case future governments start grasping for silver bullets.

It’s ineffective

We can talk about philosophy later, but let’s start with a pretty fundamental objection: dental x-rays are simply not a reliable way of establishing age.

No two mouths are alike. I’ll add my own to that list, as I still sport two of my baby teeth.

Children and young people mature at different rates, so the level of accuracy in these tests changes with time. And these x-rays can estimate age in younger children much more accurately than in adolescents. So as children mature at different rates, the potential margin of error gets ever larger with age.

For example, the third molars, commonly known as wisdom teeth – the last permanent teeth to develop – can form any time between the ages of 16 and 23, and a small proportion of individuals never develop third molars at all (I’ll have to pop my name to that list too).

A 2010 study of 300 young people aged between 11 and 25, whose age was determined based on dental x-rays, showed this method of testing consistently over- or under-estimated age, with a two-year average difference between dental and known age.

So if you are searching for a litmus test that will tell you whether a subject is 17 or 19 years old you won’t find it here.

It’s inappropriate

A few MPs and pundits have found it hard to acknowledge the codes health practitioners sign up to, which make this test a no go.

We must always act in the best interest of our patients when providing a medical procedure. And it is beyond question that the process of radiography is a medical procedure that should be carried out only for medical purposes, and where the patient stands to benefit.

Now many people might not consider this test an invasive procedure. However, x-rays do carry a small risk of possible long-term physical impact, and current best practice in this area dictates that exposure to radiation should be kept as low as reasonably possible over a lifetime. They should be carried out sparingly and where there is a well-defined potential clinical benefit, which must always outweigh the potential clinical harm.

As taking x-rays to determine the age of an individual carries no clinical benefit, it frankly isn’t appropriate to expose a patient to the potential clinical harm it can cause.

It’s unethical

Our lawmakers cannot simply dispense with fundamentals like consent to show they are “taking action”.

It is a legal principle that before practitioners carry out any medical procedure, the recipient – or someone who can consent on their behalf – must be given a full understanding of the nature of the procedure, its significance, impact and potential consequences before signing up to it.

For the children arriving from Calais, this would be a difficult task without English as a first language. Consent may also be required from a suitable adult. Yes, these children may be unaccompanied, but it does not mean the need for valid consent and protecting the child’s best interests can simply be ignored.

The letter of the law might be inconvenient, but it is a requirement that can only be compromised where the urgency and necessity of the circumstances demand rapid action in a patient’s best interests. And even in these circumstances the validity of treatment has sometimes ended up being challenged in the courts.

Given that taking x-rays in order to determine age is not medically justifiable in the first place, the urgency justification really doesn’t come into play. And that means dental colleagues – in the absence of valid consent – could find themselves performing an act that constitutes a criminal battery.


In the past, ministers have debated whether there is a credible “public interest” case that might override these little legal or philosophical objections. But these practical and ethical concerns can’t really be separated.

But why bother constructing a case for a test that frankly isn’t much cop? Dentists can only hope the latest message from the Home Office marks the beginning of a consensus, which draws a line under a decade of wishful thinking.

Judith Husband, Chair of the British Dental Association’s Education, Ethics and the Dental Team Working Group.