George Osborne stands behind the bar during a visit to officially re-open The Red Lion pub following a major refurbishment in Westminster on February 25, 2014. Photograph: Getty Images
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How big is Osborne's black hole? The problem is we don't know

The level of austerity required varies hugely depending on how much growth is thought possible.

Today's FT story on George Osborne's "£20bn black hole" might appear puzzling at first. With the British economy growing faster than that of any other major western country (albeit after three years of stagnation), shouldn't the public finances be getting better, not worse? On one level they are: borrowing for 2013-14  is currently £4bn lower than last year. But the problem for the Chancellor is that the models used by the Office for Budget Responsibility (the budgetary watchdog he founded in 2010), which the FT has replicated, deem this improvement to be almost entirely cyclical (temporary), rather than structural (permanent). While the body's short-term forecasts have improved, its long-term forecasts have worsened. Osborne's cuts have permanently dented the economy's growth potential. The result is that the structural deficit (the part of the deficit that exists regardless of the level of growth) is now estimated to be even bigger than first thought, and that means even more austerity will be needed to balance the books. 

The problem with all of these forecasts is that they hinge on one highly uncertain judgement: the size of the output gap. The output gap (or the level of "spare capacity") is the difference between current and potential growth. If the gap is thought to be large, then a significant chunk of the deficit can be eliminated over time through growth, rather than spending cuts and tax rises. But if it is thought to be small (the OBR puts it at 1.8 per cent), then even greater austerity is needed. At present, the OBR estimates that the structural deficit will be £85bn this year, while the total deficit will be £111bn (meaning £26bn of austerity is avoided). But the FT''s updated forecasts suggest that the difference between the two might be smaller than thought, hence the warning of a "£20bn black hole". 

The complication for Osborne (and Ed Balls, who has pledged to eliminate the current deficit by the end of the next parliament) is that economists are hugely divided over the potential for higher growth (the Independent's Ben Chu has a useful graph of their differing forecasts here). The Bank of England's Monetary Policy Committee is even more pessimistic than the OBR; it estimates that the output gap is just 1-1.5 per cent, meaning that austerity of £91-97bn will be needed to Osborne to meet his target of running a budget surplus by 2018-19. But the market, on average, is more optimistic than both; it assumes an output gap of 2.7 per cent, meaning the level of austerity required falls to £77bn. Others are even more optimistic. The National Institute for Economic and Social Research (NIESR) puts the output gap at 4.3 per cent, with £60bn of austerity required, at least £30bn less than assumed by the Bank of England. 

The danger highlighted by some economists is that an overly pessimistic estimate could lead to austerity being applied more severely than necessary. As Andrew Goodwin, senior economist at Oxford Economics, has said: "Oxford Economics analysis suggests that the economy has a significantly larger amount of spare capacity than the OBR estimates which, in turn, suggests that the medicine of austerity could end up being applied in a dose higher than the patient actually needs."  This calculation matters as much for Labour as it does for the Tories. The level of growth thought possible will determine the amount the party can spend on its priorities - housing, childcare, employment, skills, health and social care - while meeting its tough deficit reduction targets. If it follows Osborne and uses the OBR's pessimistic forecasts, it could end up with a minimalist manifesto it later regrets. 

Wonkish it might be, but the output gap is probably the most important number in British politics. 

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