POLITICS

You may have missed it, but Liberal Democrat MP Dr Jenny Tonge certainly didn't. Last Friday was Florence Nightingale's 180th birthday, or would have been had that formidable woman not lasted only half that span (1820-1910).

What did Dr Tonge do to celebrate? She staged one of those parliamentary adjournment debates, orphans of the Westminster night, to complain about hospital hygiene.MRSA has become a 'huge problem', and we are 'slipping back to the dirt and carelessness' of preNightingale days, she told Gisela Stuart, the junior health minister, obliged to mop up these debates.

What should we do about it? Well, the Richmond Park MP (herself a GP and whose husband is a hospital consultant) wanted all sorts of improvements, ranging from better pay for laboratory staff, better supervision of contract cleaners (who are 'no longer part of the ward team'and are paid 'scandalous'wages, she noted), better infection-control practice, and above all more practical training.

As far as I could see, this boiled down to more washing of hands - nurses' , doctors', everyone's. That National Audit Office report in February, which said that hospital-acquired infections may cost the NHS£1bn a year, caused some merriment by printing a 12point comic strip showing how to wash your hands properly.

But it didn't amuse those in Richmond Park. Some 9 per cent of patients - 100,000 a year, says the NAO - have a hospital-acquired infection; in US hospitals it remains a major killer.

I thought it was a perfectly sensible report, but Dr Tonge thought it a scandal that 150 years after Nurse Nightingale cleaned up those Crimean War wards, ably assisted by Mary Seacole, who is a black role model in schools these days, 'the NAO has to tell people working in the NHS to wash their hands and keep their wards clean'.

At the end of what must have been a gruelling week for health ministers - all those media reports of medical arrogance and incompetence - Ms Stuart did her stoic duty. Some 93 per cent of 112,000 heart patients surveyed said the facilities had been 'fairly clean or clean'.

That has always been my experience.But you and I both know enough people who say otherwise. To make sure our hospitals correct illness, not inflict it, staff must know what is expected of them, they must have the tools to maintain cleanliness and they must be monitored, Ms Stuart told MPs .

In 1997 there hadn't been much of this, but the DobsonMilburn programme of independent scrutiny - non-clnical as well as clin ical monitoring-will drive down what Ms Stuart called 'unacceptable variations across the country and drive up standards'.

As early as 1995 a Department of Health working group estimated that 30 per cent of infections could be avoided by better practice.As for contracted-out cleaning services - or market-testing, as we now say - ongoing evaluation of their performance by trust managers is now required to prevent the backsliding that Dr Tonge detected.

Local evaluation with progress 'monitored at the centre', as she put it. Nurse Nightingale, who vetted all her nurse trainees personally, could not have put it better.

Yet when I rang Labour's Sam Galbraith, himself a surgeon, to get what medical folk call a 'second opinion', he was frankly sceptical. 'Infection has always been around. In recent years it's been significantly reduced.You get more infection because you handle more complicated cases, ' he explained, rattling off enough medical science to confuse me. Contractedout cleaning staff? Nothing to do with the problem, he insisted.

A Scottish Office minister who went home to become a minister under Donald Dewar, Mr Galbraith has survived major surgery himself.

And it was only the fact that First Minister Dewar fell behind Mr Galbraith as they walked across the tarmac at Heathrow that alerted him to the fact that his old friend, evidently out ofbreath, must be ill.This was the start of the process which led to Mr Dewar's successful heart operation last week.

Without that random intervention things might have been more serious.But this has nothing to do with hospital infections.On that Mr Galbraith is adamant.'If you don't have any, you're not doing anything.'

As for NAO investigations into the NHS, he has his doubts about some of them: they get mixed up with people who have bees in their bonnets, he ventures.

Not something that Ms Nightingale would had missed.