Perhaps the most depressing thing about the news of filth in hospital kitchens is how quickly it will be forgotten: shrugged off on to the ever-growing heap of anecdotes about slovenly hospitals. The Freedom of Information Act, invoked by the Liberal Democrat Norman Lamb, informs us that of 368 NHS and nine private hospitals checked, 173 have mucky kitchens, 57 employ sluttish caterers, and scores don’t know how to store food safely. In Winchester a food handler samples food and licks his fingers; in Ashford, Kent, full-grown cockroaches frolic; in Croydon used syringes are left on meal trays . . . well, let me not spoil your breakfast.

But it is good to be told these things by professional inspectors – just as we were four years ago, when the Government huffed that every hospital must have a “director of infection control” and John Reid promised “a raft of measures”. It is useful not to rely only on anecdotal evidence; yet we all know by now that simple standards of hospital cleanliness have plummeted. There are bloodstains on the shower walls, black greasy cracks in skirtings, filthy keyboards, nameless smears. The modern nurse’s tolerance for dirt is axiomatic: relatives remonstrate with idly chattering nurses when finding their loved ones on stinking wet sheets; those syringes on meal trays were not put there by caterers.

There is an allied problem. Not only might food be unhygienic but it may not be eaten at all. Weak patients get offered food they cannot cut or lift to their mouths, and see it whisked away uneaten by auxiliaries while nurses – academically trained but blind to the obvious – do nothing. A 90-year-old recovering from gastric trouble has a plate of liver and bacon slapped down in front of her rather than a milk pudding. The daughter of a dementia patient reports that her mother ate nothing for two days because the nurses say piously that she “declined food”, and that to coax her would breach “human rights”. It is not even economically sensible, this attrition of basic services in an age of advanced medicine. In another routine anecdote, a woman who had been on life-support for weeks (cost, £2,000 a day) found her first meal was a dry ham sandwich – the hospital food budget was only £1.50 per patient.

Feeding and cleanliness were once the bedrock of nursing. The problem is that the bedrock became so cluttered with modern marvels and innovations that we did not see it crumbling. Even with the rise of hospital-acquired infections the response is muddled denial: vapid promises of “directorates” and “action plans” such as “encouraging” staff to wash their hands. But as a veteran nurse said in The Times: “Hospitals will never be clean again, because contracted staff simply want to earn their wages . . . when I started out, each ward had its own cleaning staff. They would kneel on the floor to clean bed wheels and climb on chairs to reach curtain rails. They were fiercely proud of their ward, and would tour it with Sister, while she checked that it was spotless.”

And Sister knew about cleaning; 25 years ago, when she was training, nurses themselves cleaned, rolled bandages, made tea; a world described by Monica Dickens in her wartime hospital memoir. In that regime lockers must be scrubbed out and the wheels of the beds kicked straight, though death and tragedy lie on either side. If a patient dribbles mince on her bedjacket it must be changed before Doctor sees it, and a frightening Sister inspects the “sluice” where bedpans are emptied: “She would sniff delicately and touch things with her fingertips, but her eye was ruthless.”

With its put-upon nurses and basic medicine it is not a hospital world the modern age would accept. But the point is that not so long ago there existed a rigorous culture of cleanliness and basic nursing. And nurses enforced it. Even 25 years ago, having a baby, I was ticked off for crossing the floor without slippers in case my feet infected the bedspread; and Sister had the power to send back food she thought inappropriate to “my breast-feeding girls”.

Discussing this cultural shift with a former nurse in her fifties, we came up with a revolutionary plan of action, involving no new “directorates” at all. Why not, we giggled, simply draft in a volunteer regiment of ex-nurses trained before 1975: opinionated middle-aged women with strong memories and no fear of offending. Every hospital would be invaded by several dozen for one month. During that month all normal taboos would be suspended: there would be no interdicts on workplace bullying, harassment, job demarcation, paperwork, or protocols of line management.

It would be a trying month, punctuated by unforgiving tuts and the sharp snap of rubber gloves. The storm-troopers would be authorised to tear a strip off anybody from the humblest cleaner to the chief executive. If staff in wards and kitchens were clearly being impeded by the system from doing their job properly, the invaders would need no appointment to interrupt meetings and tell the executives what was what, marching them downstairs to look at the problem and perhaps scrub it personally. Fingers would be run along skirting boards, lavatory seats inspected like space-shuttle components, meal trays and their deployment watched by sharp Sisterly eyes, grubby visitors turned away to have a wash. Rockets would be administered without pity or political correctness. Staff (even executives) would be found weeping in the sluice from time to time, and the word “bitch!” would be muttered.

But slowly, pride might return and staff get the idea. And at the end of the month selected storm troopers would deliver their report to Mr Brown and Mr Johnson, not on some piece of paper to be shuffled away, but verbally and powerfully over tea at Downing Street. And the cups had better be clean.

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