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Mr. Hutton: It is a matter for individual national health service hospitals to decide whether or not to charge for car parking and the level of charges in the light of local circumstances. Information on this activity is therefore not routinely collected centrally.
Many car parking charges are set to cover the cost of maintenance and security of the car park such as adequate lighting, car park attendants and security officers. If charges were not made to offset these costs the money would have to be found at the risk of cutting patient services elsewhere. There are therefore no plans to instruct hospitals to abolish car parking charges for visitors.
Miss Melanie Johnson [holding answer 15 March 2005]: Information on emergency readmissions for all ages, within 28 days of discharge, has been collected since 200203. Prior to that date, the quarterly information related to the over 75 age group only.
|Rate of 28 day emergency admission for people of all ages (percentage)|
|Quarter||Number of people of all ages discharged from hospital||Number of people of all ages readmitted as an emergency within 28 days of discharge|
Mr. Lansley: To ask the Secretary of State for Health what action he is taking to publicise the steps that the public should take to minimise the risk of transmission and infection in the event of an outbreak of an influenza pandemic. 
Miss Melanie Johnson: The United Kingdom, in collaboration with the World Health Organization and international colleagues, is supporting research, developing seedstock for pandemic strains and continuing discussions with manufacturers about the development of a vaccine in the event of an influenza pandemic.
Mr. Lansley: To ask the Secretary of State for Health when the phases in the UK Influenza Pandemic Plan published in March 1997 became inconsistent with the phases which trigger public health action as defined by the World Health Organisation; and when he expects the next change in these phases by the World Health Organisation. 
The World Health Organization is currently considering modifications to the phases used to the international spread of an influenza pandemic. We understand these are to be published shortly. Any necessary amendments will be made to the UK plan.
Mr. Lansley: To ask the Secretary of State for Health on what basis an incubation period of one to three days, as described on page 25 of the UK Influenza Pandemic Plan, was assumed for planning purposes in the event of an outbreak of an influenza pandemic; and whether he plans to model the outbreak of an influenza pandemic with an incubation period of different length. 
Miss Melanie Johnson: The incubation period of influenza ranges from one to seven days, but is commonly two to three days and this range was therefore used for planning purposes. There are no plans to extend this aspect of modelling.
Mr. Lansley: To ask the Secretary of State for Health when he expects to develop a strategy for the optimal use of antivirals in tackling an influenza pandemic; if he will publish this strategy; and what part the National Institute for Clinical Excellence will play in developing it. 
Miss Melanie Johnson:
We will consult the National Institute for Clinical Excellence for its views on the use of antivirals when developing the strategy, which will take into account comments received on the plan and be published in due course.
22 Mar 2005 : Column 760W
Mr. Lansley: To ask the Secretary of State for Health when he will publish guidance for NHS organisations for use alongside the UK Influenza Pandemic Plan, as mentioned on page 7 of the plan; and for which organisations he expects to produce a checklist to follow, as mentioned on page 7 of the plan. 
Mr. Bruce George: To ask the Secretary of State for Health what action he is taking to monitor prescribing of isotretinoin to women of child bearing age with particular reference to EU regulations on pregnancy prevention. 
Miss Melanie Johnson: Isotretinoin (Roaccutane) is a prescription-only medicine indicated for the treatment of severe acne, such as nodular or conglobate acne or acne at risk of permanent scarring. Its use is limited to specialists in dermatology with expertise in the use of systematic retinoids for the treatment of severe acne and a full understanding of the risks of isotretinoin therapy and monitoring requirements.
The safety of isotretinoin has been closely monitored by the Medicines and Healthcare products Regulatory Agency (MHRA), with expert advice from the Committee on Safety of Medicines, since it was approved in 1983.
Isotretinoin is known to harm the foetus if used during pregnancy and the product information has always carried stringent warnings to guard against its use during pregnancy. The product information for isotretinoin products was recently reviewed at a European level by the Committee for Human Medicinal Products. This has resulted in consistent updated advice to prescribers and patients throughout Europe, including the introduction of a pregnancy prevention programme. The pregnancy prevention programme consists of three parts; an education programme, therapy managements and distribution controls, which work together to raise awareness of the serious consequences for pregnancies exposed to isotretinoin.
All female patients will receive information about isotretinoin, the risks associated with exposure during pregnancy as well as information on contraception. If clinical judgment is that a woman is not at risk of becoming pregnant she may not need to be subject to all of the requirements of the scheme in order to receive treatment with isotretinoin.
The effectiveness of the pregnancy prevention programme is being closely monitored by the MHRA and other European member states. The marketing authorisation holders are required to submit regular reports six monthly for the first two years and annually thereafter on the effectiveness and implementation of
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the scheme across Europe. The pregnancy prevention programme has not yet been launched in all member states, but, in the first six months of launch in the first five member states, there were no new cases of pregnancy exposed to isotretinoin in those countries.
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