HALF the hospitals in England have only “acceptable” levels of cleanliness, assessments by the Department of Health show.

But only 24 were rated poor and three unacceptable, as the department issued instructions designed to make hospitals cleaner places.

The new guidance gives instructions on how often different areas of the hospital should be cleaned. Very high-risk areas, such as intensive care units, should have floors cleaned twice a day with a wet mop, be machine cleaned once a week and stripped and resealed once a year. Low-risk areas, such as corridors, need a full clean only once a week and a machine clean once a quarter.

The fact that the department should feel the need to tell hospitals how to keep their premises clean indicates some lack of confidence in local management, despite repeated promises to decentralise control.

The latest inspections found that 10 per cent of hospitals (118) were “excellent”, 456 “good”, 583 “acceptable”, 24 “poor” and 3 “unacceptable”. Among those in the last two categories are many mental health trusts (15 out of the 27), but some prominent acute trusts also feature, including the Radcliffe Infirmary in Oxford, Mount Vernon Hospital in Northwood, and Hitchin Hospital in Hertfordshire.

Of the three units rated as unacceptably dirty, two are run by Manchester Mental Health and Social Care Trust (the Edale Unit and York House, at Manchester Royal Infirmary). The other trust criticised is the Worcestershire Mental Health Partnership NHS Trust, based in Worcester (the Clifton and Abberley wards).

Lord Warner, the Health Minister, said that there was no clear link between hospital cleanliness and rates of infection by the superbug MRSA, though it was not unreasonable for the public to make such a link.

“If a hospital is well cleaned, it is more likely that it will have low infection rates. But you could still get an infection in a spotless hospital,” he said.

He said that the rise of MRSA had stalled in the past few years, coinciding with the department making mandatory the collection of figures on MRSA bloodstream infections.

But hospital infections continue to rise. All that has stopped increasing is the proportion of infections caused by MRSA, which have stuck at about 40 per cent of the total.

Next week the department is holding a “science summit” at which experts from home and abroad will discuss ways of controlling MRSA more effectively.

Whether hospital cleaning is contracted out or done in-house does not seem to be a factor in the cleanliness scores. Of those in the excellent category, 11 per cent are contracted out and 10 per cent done in-house. In the good category, 36 per cent are contracted out and 40 per cent done in-house. But among the poor and unacceptable hospitals, 18 of the 27 are contracted out.

Paul Burstow, the Liberal Democrat health spokesman, said: “Government targets hamper the effort against infection. Patients are shunted from ward to ward and there is not enough time to clean beds properly between patients.

“Infection-control staff are often ignored and the spread of infections continues.

“Ministers’ promises to fly in experts from overseas is an insult to experts in this country. We have infection-control nurses and doctors who know what needs to be done. The problem is that they are not being listened to.”

Andrew Lansley, the Shadow Health Secretary, said: “The Government’s plan to combat MRSA is the 23rd in a long line of initiatives started since 2000. These headline-grabbing schemes hide the reality that hospital-acquired infections are increasing. Whitehall targets have been a key cause in the proliferation of MRSA since 1997 because in order to meet a target, wards are not shut down for cleaning.”

Hospital-acquired infections, including MRSA, are blamed for 5,000 deaths a year. But campaigners claim that the true toll could be more than twice this figure.

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