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Mr. Yeo: To ask the Secretary of State for Health how many responses the West Suffolk Primary Care Trust received to its consultation document into the closure of the Walnuttree and St. Leonard's hospitals in Sudbury; and if she will publish them. 
Mr. Lansley: To ask the Secretary of State for Health what steps she is taking to improve the care given to those with hypertension; and what steps she is taking to encourage self-monitoring of blood pressure. 
Mr. Byrne: The quality and outcomes framework that underpins the existing general medical services contract contains 11 quality indicators relating to measurement of blood pressure, including a section devoted to recording diagnosis and ongoing management of high blood pressure.
The Department's public health campaigns make a significant contribution to preventing hypertension. These include campaigns on smoking and healthy eating, and the Food Standards Agency's campaign on reducing salt consumption.
The National Institute for Health and Clinical Excellence and the Newcastle guideline development and research unit have issued a guideline on the diagnosis and management of hypertension, or high blood pressure, in adults in primary care. The routine use of home monitoring devices for blood pressure is not currently recommended because their value has not been adequately established and their appropriate use in primary care remains an issue for further research.
Mr. Lansley: To ask the Secretary of State for Health what steps she is taking to inform health professionals on how best to diagnose hypothyroidism; what current best practice is in relation to the diagnosis of hypothyroidism; and whether she plans to instruct the National Institute for Health and Clinical Excellence to draw up guidance on the diagnosis and management of hypothyroidism. 
PRODIGY guidance (www.prodigy.nhs.uk) offers advice on the management of a range of conditions and symptoms, including hypothyroidism, that are commonly seen in primary care. The guidance is
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advisory and has been developed to assist health care professionals, together with patients, make decisions about the management of the patient's health.
We are committed to keeping all interventions and management regimes under review and will consider commissioning guidance from the National Institute of Clinical Excellence (NICE) if these have a significant impact on patient care, national health service resources, or Government health related policies. We have no plans at this time to instruct NICE to develop guidance on the diagnosis and management of hypothyroidism. or Government health related policies. We have no plans at this time to instruct NICE to develop guidance on the diagnosis and management of hypothyroidism.
Mr. Baron: To ask the Secretary of State for Health how many (a) nurses and midwives and (b) doctors were internationally recruited through bilateral agreements or memoranda of understanding in each year for which figures are available, broken down by country. 
|Year of registration|
|Year of registration|
Mr. Hunt: To ask the Secretary of State for Health how the management and administrative costs referred to in the guidance on commissioning a patient-led NHS issued on 28 July by Sir Nigel Crisp will be defined; and how much was spent on them in the NHS financial year 200405. 
Mr. Byrne: In Commissioning a Patient led NHS", management and administrative costs are defined as the pay costs, non-pay costs and the cost of estate relating to the management and administration in primary care trusts (PCTs), strategic health authorities (SHAs) and ambulance trusts. Pay costs relating to management and administration are separately identified in a note to the audited annual accounts of SHAs and PCTs.
The maternity records collected through the Hospital Episodes Statistics system are usually identified only to trust level, rather than to any specific unit within the trust. Some trusts provide information regarding the staff group with lead responsibility for care for example, midwife-led or consultant-led, but this does not allow the identification of midwife-only units.
Mr. Nicholas Brown: To ask the Secretary of State for Health (1) what advice she has received from the National Institute for Health and Clinical Excellence on the effectiveness of Alimta, in combination with other interventions, in ameliorating mesothelioma; 
Jane Kennedy: Alimta is licensed for the treatment of malignant pleural mesothelioma and can be prescribed across the national health service for those patients who fit the licensed criteria with the agreement of the clinicians and primary care trusts (PCTs) concerned.
Funding for licensed treatments should not be withheld because guidance from NICE is unavailable. In these circumstances, we expect PCTs to take full account of available evidence when reaching funding decisions. This is confirmed in Health Service Circular 1999/176", which asks NHS bodies to continue with local arrangements for the managed introduction of new technologies where guidance from NICE is not available at the time the treatment or technology first became available.
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Available figures relate to the number of deaths from drug-related poisoning where methadone was mentioned on the death certificate. The most recently available information is for deaths in 2003. It is not possible to identify from death certificates which substance was the primary cause when more than one was involved. Figures related to the number of deaths where methadone was mentioned on the death certificate, either alone or with other substances, are shown in the table below. This table is taken from information published in the annual report: Deaths related to drug poisoning: England and Wales, 19992003", which was published in Health Statistics Quarterly 25 in February 2005.
|Methadone mentioned alone(15)||Methadone and other substances||Total mentions of methadone|
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