The Treasury has put together data on how its policies impact on people. Ministers have been sluggish at using it. (Photo:Getty)
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Hard choices lie ahead - here's how the next government might make them

The next government can use data to make cuts more effectively and in a fairer way than this one

One of the unforeseen consequences of coalition, combined with fixed-term Parliaments, is that we currently have a lame-duck government. Nothing is happening in terms of government policies – instead ministers are promising, on behalf of their own party not the government as a whole, to do things if they are elected to govern alone. The consequence has been the announcement or reannouncement of a series of gimmicks (for example, benefit sanctions for addicts refusing treatment) that the government had sensibly previously dismissed as impractical or counterproductive.

So civil servants aren’t doing any policy work. Instead, they are preparing for the really big event of the first few months of the next Parliament – the spending review.  As the Office of Budget Responsibility has pointed out, the government’s current “plans”, set out in the Autumn Statement, imply that total public spending, relative to GDP, would fall to its lowest level in 80 years.  The OBR also made it clear that these were simply assertions by the government as to what it would do – there are no actual spending plans as yet beyond 2015-16. For this reason, they should not be taken that seriously; indeed, the definitive survey of UK macroeconomists by the Centre for Macroeconomics found that only 1 in 10 thought the government’s plans were credible.

But there will be a spending review. And there will be, in the usual cliché, “tough choices” – even tougher than usual. As FlipChartRick’s venn diagram memorably puts it, anybody who thinks that you can balance the budget, not put up taxes and maintain public services at a reasonable standard is “living in LaLa land”.

Before the 2010 spending review, the Prime Minister said “we are all in this together”.  But of course, and inevitably, some individuals and groups lost out more or less than others. That doesn’t make the decisions taken then “unfair”; some were deliberate political choices, made by an elected government in the full knowledge of the consequences; some reflected the patterns of existing public spending and services.

However, any government has both a moral and a legal obligation to do its best to understand the consequences of its decisions – preferably in advance.  In particular, the 2010 Equality Act imposes a requirement on the government to take account of the impact of its decisions on equality of opportunity between different groups.   Since 2011, the Equality and Human Rights Commission has been looking at how that worked in practice in the Treasury and Whitehall in the 2010 Spending Review and since – and what lessons can be learned for the next Parliament. 

The EHRC also commissioned NIESR, and my colleague Howard Reed at Landman Economics, to model the overall impact of tax and spending decisions.  There is more about the background here; and more about our findings here.

 I would sum our findings as two-fold. First, the Treasury did its best (and better than it ever did before) with limited resources and inevitably imperfect data, to analyse the consequences of tax and spending decisions taken in this Parliament on different groups. Considerable progress has been made, and they deserve credit.  But, second, that with relatively limited extra effort and resources more could easily be done; and, perhaps more importantly, that if more analysis had been done decisions might well have been different.  One chart makes the point. It is difficult (although, admittedly, not impossible) to believe that a government genuinely committed to the principle of “we’re all in this together” would have deliberately chosen to implement a set of measures that bore far more heavily on low-income disabled families than any other single group.

Today, however, the EHRC publishes its final report, and it looks forwards not backward.  It makes five key recommendations:

  • Making sure the government has the best possible advice by nominating a body to have overall responsibility for advising Ministers on the impacts of tax and spending decisions on different people in society, including women, ethnic minorities and disabled people.
  • Assessing the combined effects on people of different decisions.  Decisions in different departments which affect women for example, should be assessed together for their total impacts.
  • Improving the coverage of evidence and analysis in the Equalities Impact Statement published alongside major government announcements, such as budgets and reviews of spending.
  • Improving the quality of data by engaging further with government departments to clarify expectations and reach a common and agreed approach on different types and sources of acceptable data and evidence.

"The EHRC, not me, is responsible for the recommendations. But for what it is worth, both as a researcher and as a former senior civil servant in the Treasury, DWP and elsewhere, I think they are practical, reasonable, and implementable; and that they would deliver a meaningful improvement in the quality of analysis available to Ministers when they make those inevitable "hard choices". "

Jonathan Portes is senior fellow The UK in a Changing Europe and Professor of Economics and Public Policy, King’s College London.

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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