My Lords, I thank the noble Earl, Lord Howe, for giving us a chance to welcome the noble Lord, Lord Darzi of Denham, to your Lordships' House as Minister responsible for health. As a leading and dedicated professor of surgery, the Minister may find it difficult to comprehend the many challenges that face the NHS as there are so many different principles.

London, with its diverse communities, has become a huge challenge to the NHS. The scourge of drug and alcohol abuse and the increasing incidence of gunshot and stabbing injuries increase pressure on it. My heart goes out to the family of the Polish care worker who was killed in crossfire last week.

A priority in patient care should be the quick release of results of tests and scans, correct diagnosis and the most appropriate treatment. That would lessen the risk of long-term disability, as was illustrated to me on a visit to King's College Hospital.

As president of the Spinal Injuries Association, I have seen many disasters occur when patients with injuries to the neck and back, which can lead to paralysis, are not treated in a specialist spinal unit. Accidents happen in so many different ways. A young electrician in Westminster who fell through a skylight landed on a spike which pierced his liver and severed his spinal cord. Once his liver was repaired, he was transferred to Stoke Mandeville Hospital for spinal treatment. The priorities are the treatment of bladder and bowels and the prevention of pressure sores. General hospitals in London lack the routines required and the trained staff.

On a visit to Lambeth Walk health centre, I found excellent fast-track testing for HIV, with the results available in a few hours, counselling if the results are positive and referrals to specialists. However, numbers of health visitors and community midwives have been cut, which is worrying in a deprived area.

So much could be said. Does the Minister know that many London hospitals, of which Chelsea and Westminster is a good example, are helped by valuable volunteers? However, no centrally collected data on volunteering are available in the NHS. If the Healthcare Commission asked trusts how many volunteers they had and what roles they played, it would be very useful.

I hope that the Minister will take up the challenge of improving prison health, which is now the responsibility of the NHS. Many large prisons in the London area have inmates who have mental health problems or abuse drugs. They have seen an increase in blood-borne viruses, tuberculosis and sexually transmitted diseases. Health staff in prisons need all the support they can get. I wish the Minister every success in his new position. I was going to say many things this evening, but due to the limited time available, I decided to write to the Minister about them. One of the issues that I intended to raise is patients who, having been transferred to a hospital specialist, have to be transferred back to the GP and then back to a hospital again if they need to see a further specialist. I hope that the Minister will be able to do something about that. We are delighted to have him here.