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My Bill would remove two major anomalies of the present timemost significantly a legal anomaly. At present, people can contract in all sorts of ways and reach agreements that will be enforced in the courtspurchase and sale contracts provide a good example, but people can also contract to make agency agreements, exclusivity agreements, service agreements, employment contracts and all sorts of agreements to do with the management and distribution of intellectual property. In all those cases, they can do so with the expectation that if there is a dispute, the agreement will be enforced subsequently in a court in accordance with its terms and subject to normal common-law safeguards, which would certainly apply to my Bill. I refer to safeguards such as no undue influence, no material non-disclosure and so forth.
Many contracts will be enforced by a court even if they are purely oral. It is only in the event of a contract that provides the transfer of real estate that a court will require a written agreement or a written contract.
There is only one other area where a signed agreement or a contract otherwise drawn up is not enforceable in lawand that is a gambling contract or arrangement. I happen to sympathise with that exception to the law, but I simply cannot think what gambling has to do with pre-nuptial agreements or why pre-nuptial agreements should be treated in the same fashion.
There have been a number of high-profile cases in the matrimonial courts recently. One thinks, for example, of the Miller case, the Charman case and the McCartney case, which is presently before the courts. Colleagues may think that those cases have inspired me to bring forward this measure at this moment, but that is not the case. In the context of some of these high-profile cases, it is true that judges have expressed the view that the present law is very unsatisfactory and unfortunately sends a signal to the public that one way of becoming supremely rich in ones own right is to marry someone who is very rich, stay with him or her for a few years and then walk off with half the proceeds. That is clearly an undesirable and unattractive aspect of the present law.
However, it was not those particular cases but rather the situation of people on very modest means that inspired me to propose this measure. I am thinking of people who have just a few assets, perhaps a family house, and who want to protect those assets not only for their own sake but more especiallyI am thinking of specific cases nowto protect their children, perhaps their children from their first marriage. The first marriage may have ended in divorce or widowhood and the person may subsequently fall in love with somebody else and want to live with or marry somebody else [Interruption.] Indeed, such changes do happen in life. Such people may want to protect the children from their first relationship from any dispute that might subsequently occur if the relationship breaks down. That is an important aspect of the potential injustice that currently occurs.
There have been suggestions that the law should be changed to provide the same regime as currently applies to married couplesin respect of the distribution of assets in the event of a breakdownto co-habitees who are not married. I am not in favour of going down that road [Interruption.] I have to say that if the House in its wisdom decided to go down that road one day, it would seem to be particularly important to have on the statute book something like the mechanism that I am currently proposing. Otherwise people currently in such a relationship would find that they faced an invidious and nightmarish choice of either ending the relationship or finding retrospectively that they face a whole number of risks and liabilities that they could not previously have contemplated and would never have voluntarily entered into.
Let me make one final point. I said that the most important anomaly that I was addressing with this Bill was a legal anomaly. I believe that to be the case, but the measure also resolves a curious geographical anomaly. In other major common law jurisdictions such as the United States and Australia, the option to sign pre-nuptial contracts exists and they are indeed enforced in law. That is also the case in a number of European Union countries where Roman law applies. One might think that the need for a pre-nuptial agreement would not be so great in such countries, because the relevant principle of Roman law states that, if a marriage is dissolved, the assets belonging to each party when the marriage was contracted are reserved to that party. Any dispute over distribution applies only to assets and liabilities that were accumulated during the course of the marriage. That principle applies in Scotland, which also has a legal system based on Roman law. Although the need for this measure might be less great in some other EU countries, the option nevertheless exists for their citizens to use it. It does not exist in England or, indeed, in Scotland.
Mr. John Redwood (Wokingham) (Con): I quite understand why someone who had been in a relationship for 20 yearsa marriage that had ended suddenly in acrimony and bitternessmight want legal reassurances before entering a new marriage. They might wish to be reassured that whatever assets they were taking with them would not be abused by the new party. They might wish to lay down what their future course might hold in the new marriage. They might wish to know whether there were tasks or functions ahead that were particularly relevant to the decision that they were making.
Bill ordered to be brought in by Mr. Quentin Davies, John Bercow, Chris Bryant, Mr. Alistair Carmichael, Paul Farrelly, Mr. Edward Garnier, Dr. Julian Lewis, Ian Lucas, Rob Marris, Mr. Michael Moore, Mr. Robert Syms and Keith Vaz.
Mr. Quentin Davies accordingly presented a Bill to provide for the enforceability of pre-nuptial agreements; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 19 October, and to be printed [Bill 137].
That this House reaffirms its commitment to equitable access to high-quality NHS care, based on need not ability to pay; regards local access to NHS services as an important aspect of quality of care; urges the development of practice-based commissioning to incentivise primary care access and the integration of GP services, out-of-hours care, urgent care and NHS Direct services; calls on the Government to publish its review of walk-in centres and patient access survey results; notes the continuing threat to community hospitals, local accident and emergency and maternity services; calls for the preparation of evidence-based service models which seek to maintain local access to accident and emergency services, and to maintain community-based treatment and diagnosis and maternal choice; and further calls on the Government to ensure the fair allocation of resources, relative to burden of disease, to secure equitable access to NHS services.
It is a great pleasure to welcome the Secretary of State and his fellow Ministers to their new responsibilities. I look forward to our exchanges across the House, and I look forward even more to having the opportunity to work together to improve the legislative, regulatory and political framework in which the NHS seeks to deliver services to patients. Despite her travails in her post, it was always the Secretary of States predecessors great privilege, and often pleasure, to meet NHS staff, as it is my great privilege and pleasure to do so. If ever one becomes tired or distressed by what happens here at Westminster, one need only visit doctors, nurses and other health care professionals around the country to be astonished at, as well as immensely respectful of, what they achieve and the way in which they go about their tasks.
For the sake of the NHS, however, I hope that the Secretary of State does not emulate his predecessor. At the then Department for Education and Skills, the right hon. Gentlemans policies were rescued by the support of the Conservatives for his Education and Inspections Bill. The time has come for him to be rescued at the Department of Health, although not by our supporting his legislation, but by his supporting Conservative-inspired legislation. We have supported the right hon. Gentleman in the pastnow it is his turn to support us.
The purpose of the motion is not to debate those proposals, as the Secretary of State plans to deliver a statement tomorrow. Following proposals from my right hon. Friend the Leader of the Opposition and myself for greater autonomy and accountability for the NHS, he will be aware that we recently suggested a White Paper containing legislative proposals. We are happy to work together to give the NHS core principles and values entrenched in legislation; a structure of greater autonomy, not only for medical professionals but for those responsible for commissioning services
for patients; greater freedoms for those who provide services as well as the ability to invest and improve services; and a strengthened accountability structure that does not all track back to the Secretary of State, as it does now. All those proposals are included in our document, which I will leave on the Table for the Secretary of State to enjoy. I hope that in the weeks and months to come we can work together in a spirit of consensus which, according to the Governments rhetoric, is one of their intentions.
May I trespass away from the subject of the motion, and say a word about the arrest of a number of doctors in relation to the terrorist attacks last weekend? The House and the public will be shocked that members of a profession dedicated to saving lives should, it is at least suspected, conspire to take lives in an indiscriminate act of terror. I hope that the House shares my view that we should not let the action of a tiny, extremist minority ever prejudice our positive view of the way in which thousands of Muslim and overseas doctors form an integral part of health care in this country. NHS employers are responsible for ensuring that doctors meet the requirements for clinical practice and, for example, in language proficiency. Checks on those entering the United Kingdom include visa and criminal record checks, for which the Foreign and Commonwealth Office and the Home Office are responsible. It is important to noteI am sure that the Secretary of State has already done sothat the code of practice for the recruitment of health care professionals from developing countries includes Iran, Iraq and Jordan, which are countries from which the UK has agreed not actively to recruit. I am sure that the House will understand if, when he responds to our debate, the Secretary of State will explain how that code of practice and the highly skilled migrants programme have been applied, and what checks are undertaken on medics who come here.
The Secretary of State has to address urgent priorities in his Department, but if he has any doubts about the scale of the problems he must tackle, he need only read the capability review published about his Department last weekend, when, as they say in business, the Department was kitchen sinking on the issues that it had to deal with. The review said that
the Department has not yet set out a clearly articulated vision for the future of health and social care and how to get there.
It had serious concerns about the setting of direction which, given the understated language of the civil service, is about as serious as it gets. There is no direction for the national health service, and there has been a failure of leadership and direction. Where my party leader has led, the new Prime Minister and the Secretary of State have followed in saying that the NHS is their priority. Constitutional affairs have turned out to be the new Prime Ministers priority but, none the less, we have led by making the NHS our immediate and first priority.
we need to do better.
more access to health services at weekends and outside normal hours, millions using NHS Direct, millions using walk-in centres, more access to GPs.
I was not sure whether that was a statement of what exists at present or of what the Prime Minister hopes will be the case. He is right that access to NHS care must be regarded as a vital aspect of the way in which quality health care is delivered. We have argued that that is the case, which is why we tabled the motion.
Mr. Nicholas Soames (Mid-Sussex) (Con): As my hon. Friend knows, reconfigurations are taking place throughout the country, especially in south-east England. Will he consider asking the Secretary of State if it is possible to call a halt to them for the moment as they are an attempt to impose one-size-fits-all structures on local health services? The Princess Royal hospital in Haywards Heath is 15 miles south of one the biggest airports in the world, five miles from a major motorway and located in a changing area where thousands of new houses will be built. It is to have its accident and emergency and maternity services taken away from it and transferred to an impossible place to get to in Brighton. Does my hon. Friend agree that it would be proper to reconsider that in light of what he has said?
Mr. Lansley: I am grateful to my hon. Friend for that intervention, and I entirely agree with his point. The new Prime Minister has stated that he must listen to what the public and NHS professionals are saying throughout the country, but he cannot do that whenas is happening in many placestop-down reconfiguration of services is being forced upon local health care economies. I was recently in Hastings in my hon. Friends part of the country. The way in which the reconfigurations are to be applied raises serious questions about both the evidential basis for them and to access the services that will result. I will say more about that.
Anne Snelgrove (South Swindon) (Lab): The hon. Gentleman believes that reconfiguration should be halted and the medical profession should be listened to. However, what he recommends is the opposite of what is being said by Professor Roger Boyle, national director of Heart Disease and Stroke. He said that reorganising services could lead to 500 fewer deaths, 1,000 fewer heart attacks and 250,000 fewer serious complications such as stroke. Does the hon. Gentleman not agree that that is a firm medical basis on which to reconfigure services?
We have always argued that it is necessary to develop services; I am unsure whether the hon. Lady attended our debate on acute services reconfiguration. She is confusing the necessity for service development with the question of whether local access to services should consequently be abandoned. I have had discussions with Roger Boyle. I entirely agree with, and have argued for, propositions such as that patients suffering from a stroke should be admitted directly to a specialist stroke unit where they can access early scanning for possible thrombolysis and early stroke care. That would address a large proportion of the figures that Roger Boyles cites. There is also the issue of access to primary angioplasty; a smaller number of specialist units will be required in order to provide access to such services. However, for such achievements in service development to be followed
through in respect of less than 2 per cent. of accident and emergency attendances it is not necessary for access to accident and emergency services to be denied to the other 98 per cent.
The hon. Member for Grantham and Stamford (Mr. Davies) is sitting next to the hon. Lady. She can ask him about this matter. He and I have argued that it is not necessary for local accident and emergency services in Grantham to be shut down simply because specialist services are available in Nottingham. I invite him to agree with me on that.
Mr. Quentin Davies (Grantham and Stamford) (Lab): I am grateful to the hon. Gentleman for allowing me to do so. I am extremely grateful to the Government as we have now saved the accident and emergency unit at Grantham hospital. That happened several weeks ago. I received a great deal of sympathy on that matter from the then Health Ministers, my right hon. Friends the Members for Leicester, West (Ms Hewitt) and for Leigh (Andy Burnham), and no sympathy at all from the hon. Member for South Cambridgeshire (Mr. Lansley). We spoke about it, and he seemed entirely uninterested in the future health of the people of Grantham. He seemed about as interested in what I was telling him as he would have been if I had been talking about mediaeval numismatics or the number of potholes in New Zealand. I was getting nowhere at all with him, but I did rather well with the Government.
Mr. Lansley: I do not know what world the hon. Gentleman is living in, but he is not living in Lincolnshire, because I remember the conversation that he and I had with the chairman of the United Lincolnshire Hospitals NHS Trust; however, I will not go further down that path.
It is not only Opposition Members who believe that it is necessary for there to be a moratorium on the service reconfigurations that are proceeding in the absence of support or evidence. The new Secretary of State for Work and Pensions, in the deputy leadership election, at least had the honesty to say that
we need a moratorium on structural change and reorganisation in the NHS.
I will come back to accident and emergency departments, but I wish to start with primary care, because we seek a primary care-led service. I wondered where the new Prime Minister had been in recent years when, during his leadership election, he talked about access to GP services, because the GP contract has reduced GP access. We do not know to what extent, because the Department of Health has failed to publish the patient access survey that it commissioned at great expense. But we do know that the introduction of the out-of-hours contract was a shambles, according to the Public Accounts Committee. We know that NHS Direct has shut 12 of its 50 call centres, including the one in Cambridge, which I visited, because the planned expansion of NHS Direct has been abandoned.
Walk-in centres have been cut back. The figures for early 2006, compared with 2005, recorded fewer people attending walk-in centres. Indeed, fewer people visit walk-in centres in a year than visit GP practices in just three days. We have also seen community hospitals closed, local A and E services downgraded and birth
centres and local maternity units threatened with closure. Care closer to home, which was a mantra of the previous Secretary of State, is turning, in many cases, into care further away from home. Care closer to home is not happening.
I welcome to the Front Bench the new Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen), who was president of the Community and District Nursing Association. We have fewer district nurses and health visitors now, but they are the very people we most need to deliver care closer to home and reduce demand for these services. It is only really when demand for hospital services is reduced that it would be safe or appropriate to reduce the supply of services. What we have at the moment is a structure that is trying to ration demand for care by restricting supply of care, and that is no good.
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