We have had a wide-ranging debate with some interesting and distinguished speakers. Thinking back to old times, it was a pleasure to hear from Steve Webb, whom I think of as an expert on the finer details of the benefits system. I did not know that he was such an expert on sperm donation as well. I realise now how wide ranging his experience is.

There was a passionate speech from my hon. Friend Mr. Burns on mental health, although I thought my hon. Friend David Tredinnick, who is well known for his support for complementary and alternative medicine, perhaps went a bit far when he said that it was possible to remove someone's head under acupuncture. However, we understand the broad point that he was making.

We had a range of distinguished speakers on the Conservative Benches: my hon. Friends the Members for Sevenoaks (Mr. Fallon), for West Chelmsford, for Bosworth, for Hemel Hempstead (Mike Penning), for Harwich (Mr. Carswell), for Shrewsbury and Atcham (Daniel Kawczynski), for Broxbourne (Mr. Walker), for Ribble Valley (Mr. Evans) and for Upminster (Angela Watkinson). That list shows that we had both the quality and the quantity on this side of the House.

There were nine speeches from Conservative Back Benchers in this debate on health and education—nine of, sadly, still only around 200 Conservative Members—so 5 per cent. of Conservative Members contributed. We had speeches from four of the 350 Government Back Benchers, so just over 1 per cent. of their Back-Bench Members spoke. We do not yet have the independent statistics commission, but I take that as meaning that five times more Conservative Back Benchers spoke. We can conclude from that that Conservative Members are five times more committed to health and education than Labour Members.

Judy Mallaber, who is not in her seat, spoke about the Congolese rain forest, but we rightly focused on health and education. The Secretary of State for Health is back in her seat. We found it extraordinary that she maintained that there was no connection between the financial crisis clearly facing the NHS at the moment and the way in which payment by results has been implemented. She maintained that that was an extraordinary coincidence, but Conservative Members understand that those two events are directly connected, as my hon. Friend Mr. Lansley powerfully argued. It is the way in which payment by results has been implemented—not the principle—that is such an important reason for the financial crisis that has been described by so many of my hon. Friends today.

I see that in my part of the country on the south coast. In Havant and Portsmouth, threats of closure face Haslar hospital, Havant war memorial hospital, Victoria cottage hospital in Emsworth, and St. Richard's hospital in Chichester. The Government say, "Do not worry, all the money is going into the rebuilding of the Queen Alexandra hospital in Portsmouth." The trouble is that the patients, GPs and other doctors prefer the smaller, local hospitals, over which the threats are hanging—some of them have already had to close. It is no good Ministers deploying the rhetoric of how much they value community hospitals when, as we have heard today by mention of so many real-life examples, local community hospitals are most under threat from the financial crisis facing the health service.

As we have the good fortune of having both the Secretary of State for Health and the Secretary of State for Education and Skills present on the Front Bench at the same time, I should like to ask them about something that combines health and education, but which has not been referred to in the debate: the financial crisis facing some universities as a result of the failure by the NHS to meet its commitments on budgets for training the NHS workers of the future.

The CMU—Coalition of Modern Universities—group says that the question marks over NHS contracts represent one of the biggest present causes of instability for modern universities, which have had their own strategies to meet demand based on previous assurances about contract requirements and prices. The group goes on to say that those universities obviously have staff and training facilities in place to meet staff-student ratios and the other requirements as required by the professional bodies which accredit the courses.

Therefore, I wish to ask the following questions of the two Secretaries of State. Will the Secretary of State for Education and Skills confirm that he recognises the financial pressures that are on some universities as a result of NHS cuts in the training of nurses, doctors and NHS workers for the future? Will the Secretary of State for Health recognise that taking NHS training through a boom-bust cycle, and driving universities into deficit and causing them to close some of those training facilities, is no way to ensure that we have the trained doctors and nurses whom we need in future? In fact, it would be a source of great comfort to us if we knew that the two of them have even communicated about that important issue which is shared between health and education.

In the Blairite spirit that makes initiatives sound like something from the Chinese calendar, the Secretary of State for Education and Skills has said that this year is to be the year of skills. We welcome a debate on the importance of skills and training, but before turning to skills, I wish to ask the Secretary of State about some of the loose ends from the Government's education legislation, because it is important that they live up to some of the commitments that they have made.

An undertaking was made in the other place that there will be an investigation into making it possible for kids in state schools to sit exams such as the IGCSE—the international general certificate of secondary education. The Government have talked a lot about raising standards in state schools so that they match independent schools. One basic way in which we could show that we are committed to that principle would be by making it possible for students in state schools to sit the same exams as are now available to students in independent schools. It is wrong that we have two nations in education, with exams for which pupils at independent schools can study but for which those attending state schools are not permitted to do so. I hope that we will hear from the Secretary of State what the time scale is for the consultation that was promised on that subject in another place.

I also hope that the Secretary of State for Education and Skills will tell us a little about the Government's commitments on academies. I was struck by the following recent newspaper headline—from The Daily Telegraph, I think: "Blair pushes for more city academies to seal legacy". Apparently, the Prime Minister was a bit worried about his legacy and was very keen to get as many academies as possible in place before he left office. Let me assure the Secretary of State that the Prime Minister need have no worries about his academy legacy. Conservative Members believe in academies, and we will support them; there is no danger to academies, or the expansion of them, from us.

I wonder whether No. 10's anxiety about the legacy was because of someone rather closer to home, whom they thought might be the real threat when the Prime Minister leaves office. I am sure that the Secretary of State will welcome our suggestion that the best way of guaranteeing the future expansion of academies is to have a smooth and orderly transition from the Prime Minister to my right hon. Friend the Leader of the Opposition, who will ensure that the academy movement carries on and extends.

We have also had statements recently from the Secretary of State about 16 to 18-year-olds. He is reported to have said that he expects them to stay on in education or to go into training. It will be very interesting to hear from him exactly what he meant by that. Within 48 hours of his making that statement, the Chancellor of the Exchequer made it clear that in his view nobody is suggesting that children who do not want to do so should stay on at school full-time until 18. So exactly what kite was the Secretary of State flying? Will he explain what his commitment was? [Interruption.] Labour Members say, "It's not about schools", but if it is about training, what form will it take?

Will the Secretary of State also confirm one of the most scandalous statistics of this Government's time in office? When we left office in 1997, there were 157,000 16 to 18-year-olds not in education, employment or training—the so-called NEETs: the people whom the education and training system has let down. That figure was already far too high. Will the Secretary of State confirm that according to the latest figures there are now 220,000 such people? Despite all the Government's efforts, there has been a 40 per cent. increase in the number of 16 to 18-year-olds who are not getting started in the basics of further education or training. So of course we need some initiatives on that. What do the Government propose to do about it?

We Conservatives know what needs to be done. We understand that those young people have become detached from education. They have lost contact with, and faith in, training because, sadly, many of them have been let down by an education system that has not provided them with the basics. Almost half of all 11-year-olds still leave primary school unable to read, write and add up. What they need is synthetic phonics—an issue so powerfully pressed by my hon. Friend Mr. Gibb—as the basis of reading, so that they can remain engaged with and attached to what is happening in the classroom. Far too many classes are still not put into sets, yet setting often enables teenagers to learn and to participate in lessons that are conducted at a speed that is right for them.

We are told in the Queen's Speech that we will have a Bill on further education. I hope that the Secretary of State will take us through it and explain today some of what he is doing. This is of course very odd. Although we have been told about that Bill, we have yet to receive the Leitch report that was commissioned by the Chancellor of the Exchequer—it is due to be published around the time of the autumn statement—which is supposed to set out the Government's skills and training agenda. The Department for Education and Skills has announced a Bill, which is presumably in the process of being drafted, before we have had the Treasury's proposals, which will be introduced next month. That seems an extremely odd way to run a Government. [Interruption.] We are indeed waiting for Gordon.

I must tell the Secretary of State that if I were to describe the slow process whereby a Government decay and lose momentum, it would be when the best that they come up with on a subject as important as education is a set of proposals to reorganise their previous reorganisation. We have now reached the stage where the "radical" new measures in the further education Bill will involve changing a structure that the Government themselves introduced within only the past few years. It is at the point when one is reorganising one's own reorganisation that people lose confidence.

In fact, the Secretary of State should take some advice from the Secretary of State for Health. If there is one reason why the NHS has got into such a mess, it is the nine reorganisations to which it has been subject. Yet what does the right hon. Gentleman propose for education? He proposes a further reorganisation. He is apparently going to get rid of local learning and skills councils—and replace them with regional learning and skills councils. However, it was only in 2000 that his predecessor, Mr. Blunkett, introduced the legislation that created the local structure. He told the House on Second Reading of that Bill:

"There will be co-ordinated planning, funding and delivery of flexible services at local level, with sufficient responsiveness and delegated power to sub-regional learning and skills councils to enable them to respond to the needs of their travel-to-work and travel-to-learn areas."—[ Hansard, 30 March 2000; Vol. 347, c. 523.]

Why have the Government changed their mind?

We in the Opposition have our disagreements with the learning and skills councils. They cost a lot of money, not enough of which gets through to FE colleges and trainers. However, we know that this country is localist rather than regionalist. My hon. Friend the Member for Harwich is an eloquent exponent of that belief. Given a choice as to where decisions on such matters should be taken, I should have more confidence in those taken at local level.

In his report of only a year ago, Sir Andrew Foster proposed a strengthening of the role of local learning and skills councils. He said:

"Local learning and skills councils need to be the pivotal centre of the local community's interest, working collaboratively with local authorities, in their new local commissioner role".

The report wanted to enhance the role of local skills councils, so why is the Secretary of State going to abolish them and shift power to the regional level? That does not seem to be the right way forward.

Another proposal in the Bill will apparently be a power to remove college principals. The lack of principle is a sort of summary of this Government. They will remove the principals, yet they claim that that will be a liberalising, decentralising measure. However, we all know that the result will be an increase in central influence and power.

I hope that the House will forgive me for being a little cynical, but when I hear that FE colleges are to get a power to grant degrees I wonder whether anything in the real world will change or whether the proposal is merely a device to enable the Government to reach their target of 50 per cent. of students receiving a higher education or university degree. The Government will not reach the target by doing anything that improves the opportunities available to young people, but merely by redefining some of the qualifications that they already receive. Will the Secretary of State say what the provision will mean in the real world, or is it simply a device for achieving the Government's target?

One other question arises in connection with the further education Bill. The briefing note provided by the Department states that it will also contain provisions to "modernise and streamline" the way in which industrial training boards "demonstrate consensus" for their levy proposals by amending the industrial training legislation. I am not absolutely sure what that means, but I suspect that the intention might just be to make it easier for training boards to impose levies on local companies.

Will the Secretary of State assure the House that the provision will not make it easier to impose levies without a genuinely voluntary arrangement? That would simply be another cost on business at a time when, as the Secretary of State knows, the evidence is that employers rarely use official training providers for the training that they need.

Opposition Members believe that the proposals in this Queen's Speech on health and education are evidence of a Government running out of steam and ideas. They have lost contact with the real crisis facing the NHS described by my hon. Friend the Member for South Cambridgeshire. They have not been able to deliver their new deal promises to improve employment and training opportunities for our teenagers, and have resorted to endless reorganisation instead of tackling the real problems facing our country.