Although more than £100m has been spent on a screening programme to prevent the sexually transmitted disease chlamydia among young people, the Department of Health does not yet know what effect, if any, this has had on reducing the prevalence of the infection.
The DoH and Health Protection Agency has come in for stinging criticism from the public accounts committee, whose chairman, Tory MP Edward Leigh said: "The Department of Health left it to primary care trusts (PCTs) to organise locally all the buying and commissioning of equipment and services needed to run the chlamydia testing programme. This hands-off approach led to duplication of effort and inefficiency. And the Department did not know how much the PCTs were spending on testing or have any mechanism to measure what impact the programme was having on levels of infection.
He went on to say there was a lack of urgency and only 5% of 15-24 year olds were being tested, against a target of 15%. When it was decided chlamydia was a big enough problem to warrant a national screening programme, it embarked upon a drawn out roll-out over five years.
Leigh said: "Recognising that this level of performance was pretty poor, the Department belatedly sprang into action in 2008 -09, by imposing a mandatory target for testing levels of 17%. As the PCTs
scrambled to catch up, an already fragmented and inefficient programme became even more inefficient and wasteful.
"This is a classic example of what can happen when the responsibility for delivering a national initiative is pushed down to local level, with little thought about the mechanisms and interventions needed at national and regional level to maintain efficiency and momentum."
MPs heard that the DoH missed an opportunity to refine the programme and to improve its cost-effectiveness, during the lengthy rollout. When PCTs increased their activity to meet the 17% target, a fragmented and inefficient programme became even more wasteful of taxpayers' money.
The public accounts committee recommended that the Department of Health 'needs to make this programme a national response to a national problem. The Department should identify the most cost-effective local delivery strategies, establish regional or national commissioning arrangements, increase testing numbers and measure the programme's impact on the prevalence of chlamydia. By improving efficiency, economies estimated at £40m a year could be made by 2010-11'.
