Health minister Andy Burnham is to urge the prime minister to encourage trusts to bring cleaning services back in-house.
Last May, Mr Burnham was charged by Tony Blair to deliver an 'engagement and communications plan' to support the current NHS reform agenda. As part of this, the minister embarked on a tour of NHS organisations, shadowing members of staff including nurses, porters and cleaners. A report based on his findings is due to go to Number 10 later this month.
Mr Burnham told HSJ that one of his key findings concerned the running of cleaning services in hospitals that had contracted the management of those services to private companies. He said he was struck by 'the distance between hospital cleaners and the rest of the NHS family', which could make it more difficult for trusts tackling hospital hygiene to 'find the levers' to make it happen.
Asked whether some trusts found it difficult to square their accountability for cleanliness with the fact they did not have direct control of the running of domestic services, Mr Burnham said: 'You've taken the words right out of my mouth. This is what I am going to say in my report.'
He went on: 'I will say we should be encouraging trusts to consider bringing their services back in-house. We won't be telling them that's what they have to do, but we will be encouraging them to look again at this, and to consider the whole picture.'
Mr Burnham was speaking just before Christmas, and before HSJ saw the findings of the government's stocktake on MRSA.
Unions welcomed the indication that the government might encourage trusts to bring contracted-out services back in-house.
Unison head of health Karen Jennings said Mr Burnham's comments signified a 'very refreshing approach, and a huge departure' from current policy.
'I actually think what he is saying now is very significant - this is about managers taking direct responsibility for the cleanliness of hospitals.'
Two years ago, the union published research linking the contracting out of hospital cleaning with a lowering of cleaning standards and an increased risk of spreading infection. The report found the number of cleaners had almost halved over two decades, since the policy to tender out services was introduced by the Conservatives in 1983.
Report author Professor Steve Davies of Cardiff University said bringing hospital cleaning back in-house would be 'a big step forward', but not enough in itself. He called for 'adequate staffing levels and an end to a tendering regime and contract culture that puts cost ahead of quality, atomises functions within a hospital and contributes to the breakdown of a team-based approach'.
The Royal College of Nursing's ongoing campaign on infection control calls for the introduction of 24-hour cleaning teams which can be rapidly deployed by nursing staff.
Head of policy Howard Catton said the union would be 'very supportive' of a shift in policy and said anecdotal evidence suggested that 'contract-based' relations with outsourced contractors had reduced flexibility in the way teams worked.