HSJ's January scoop about the enduring problems with MRSA and Clostridium difficile yielded parliamentary fruit the other day in the shape of a Tory-initiated Commons debate in which this magazine received generous publicity. Excellent.

Amid the eye-catching charges and counter-charges between indignant MPs, none (in my opinion) quite matched helpful new research showing that the way to keep bugs at bay in the kitchen (and in hospitals?) is to regularly microwave the dishcloths for two minutes. Less helpful news reports came from Exeter, where a patient who went to the loo came back to find her bed occupied.

Plenty of bug sharing there, I'd guess, high bed-occupancy rates being part of this problem: it was all part of a tricky week for Patricia Hewitt's health team.

Shadow health secretary Andrew Lansley admitted that the current MRSA crisis had begun in the Tory years before 1997. But he was scornful of ministerial failure to meet John Reid's pledge on 30 November 2004 that infection rates would be halved by next year.

Yes, rates are falling (8 per cent last year), but are 27 per cent short of the Reid target. Hence the dispute between universal screening of new patients, done in some countries, and ministers' focus on high-risk patients.

As usual in these battles, a major target is, well, targets, in this case the national ones for cutting MRSA (which ministers are not going to abandon) and local ones for twice-as-lethal C difficile - a sensible response to the problem, said Ms Hewitt amid Opposition derision.

Technical debates about alcohol rubs and gel for handwashing at every bedside are above my pay grade. And ministers are surely right to confirm the point made forcefully by ex-nurse Laura Moffatt (Labour, Crawley) when she said the source of much MRSA was 'you', ie that there is a much higher incidence of such infection in the general population, which brings it into the ward.

But it makes me nervous to hear claims that economies prevent theatre staff in some hospitals wearing masks or caps, that some nurses wear their uniforms in the street, to take the kids to school or visit Asda (some MPs wondered if uniforms should be laundered in hospital). In the same way, the need to stop family visitors sitting on the patient's bed makes me think.

What I thought about was a succession of conferences I have attended in the past few weeks at Number 10, with Unison and local government chiefs, where policy,makers have grappled with how best to improve public services for demanding voters without employing more staff or spending more money.

Why? Because extra spending isn't going to happen much in the new three-year spending cycle Gordon Brown is set to announce this year - hence the drive to make services, courts, police, schools and hospitals 'smarter'. In his Times column the other weekend, the often perceptive Matthew Parris mocked the graphic issued by the Number 10 strategy unit after one seminar - unfairly, I think. Like all these seminars, it was trying to tease out new insights from which to draw up policies. In this instance, what Parris dismissed as the 'pink doughnut' graphic identified six 'clear aims and objectives' as being services that are 'equitable, efficient and value for money; universal; responsive; empowering; excellent; and innovative.'

Although Unison's conference on the future of the NHS, later the same week, was scornful of most market-oriented solutions, its declared goals would not be so different.

By a pleasing coincidence, relevant to the MRSA debate, both Tony Blair and David Cameron (speaking at a rival seminar the same day), talked about the need to 'change the culture' - to find ways to help and encourage people to change the way they think and behave about certain issues, which relate to the public services they expect. Governments aren't very good at this, and they know it.

The way patients treat their own health is one factor. Our intolerance to smoking - virtually compulsory when I was a teenager, now close to being illegal - is one obvious example. Fighting the bad-diet habit may take just as long. But what seems to be the lax attitude of some NHS staff to hygiene on the ward is another factor. Has complacency arisen from today's over-reliance on antibiotics? Just a thought.

Michael White is assistant editor (politics) of The Guardian.