Shadow health secretary Andy Burnham at the Labour conference in Brighton last year. Photograph: Getty Images.
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HS2 critic Andy Burnham to vote in favour tonight

Shadow health secretary will back the bill, despite previous criticisms, as it only applies to the first phase of the project.

Andy Burnham caused some ripples earlier this year when he refused to rule out voting against High Speed 2 in an interview with me for the NS (for which he was swiftly slapped down by Ed Miliband's office). He said then: "I’ve given no guarantees about supporting it. I’m not talking as a frontbencher here, I’m talking as the MP for Leigh. I will not let my constituents carry on paying through their taxes for the rail network when they don’t have reasonable access to it. It’s as simple as that. If the government’s going to lay new railtrack in my constituency, it can bloody well give us a station."

When I asked how he would respond if the government did not meet his demands, he suggested that Labour (which backs the project) would have to suspend collective responsibility and allow him to vote against the rail project. "If they don’t look again at the depot, I’d have to say to my own whips: 'everyone's constituency is going to be affected differently and everyone’s going to have to account. You can’t have a blanket position because it doesn’t affect everybody equally does it?'"

With this in mind, I asked a spokesman for Burnham whether the shadow health secretary would be voting in favour of HS2 tonight. He confirmed that he would be, but rightly noted that the vote covers the first phase of the scheme, "which only goes as far as Crewe" and therefore does not extend to Burnham's constituency. It is the vote on the second phase of the project (north of Birmingham), for which a separate bill will be tabled, that will be the real test of his position.

After Ed Balls's threat to withdraw support from the project last year failed to lead to outright opposition, it looks increasingly likely that Labour will continue to back the government. Shadow transport secretary Mary Creagh said yesterday: "Labour is supporting HS2 to cut congestion on the railways, better connect our great cities and help deliver a One Nation economic recovery.  HS2 will link and help regenerate our cities in the Midlands and North, get young people into work and help our small businesses to grow.

"The government has finally brought this Bill to Parliament after four years of delays and mismanagement which have caused costs to rise.

"We will continue to hold the government to account for keeping costs down on the project as there can be no blank cheque for this or any other project."

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