Hospitals were last night accused by parliamentary spending watchdogs of "an appalling lack of progress" in tackling superbugs and other causes of serious infection in patients.
The government was said to be "all at sea on the cost and extent" of the problems as Edward Leigh, Tory chairman of the all-party Commons public accounts committee, suggested it was losing ground in tackling the politically embarrassing threat to patient care.
Official figures show that incidence of the main bloodstream infections caused by the Staphylococcus aureus bacterium rose by 8% in two years to 19,311 in 2003-04. In nearly 40% of cases, the bug was MRSA - resistant to the antibiotic methicillin. The MRSA rate is among the worst in Europe.
But there is still no clear picture of how many people die from infections. The best guess remains the 5,000 for all hospital-acquired infection estimated by the National Audit Office four years ago. More recent work by the Health Protection Agency suggests 800 deaths a year linked to MRSA after phenomenal rises in incidence over the last decade.
Mr Leigh's remarks came as the NAO criticised progress by the government and the NHS since it raised the alarm in 2000.
On Monday, John Reid, the health secretary, published a revamped battle-plan to address the problems, putting at its heart patients' right to complain about cleanliness and hygiene. But this made no more than a passing reference to fears that the drive to rush people through hospitals and reduce waiting times had helped fuel the increases in infections. Mr Leigh said: "The flurry of activity by hospitals in establishing systems and processes for countering hospital-acquired infection has simply not translated into real progress on the ground.
"Good infection control is being thwarted by high bed occupancy levels, a lack of isolation facilities and too many patients with different conditions being placed together in wards."
It was outrageous, he said, that the NAO was still highlighting poor hospital cleanliness, lax handwashing by staff, under-resourced infection control teams and a culture in which good infection control was regarded as someone else's problem.
"People in hospital for treatment should not have to fear a possibly deadly infection while they are there. They should certainly not have to wait another four years for the NHS to stop sitting on its hands and start taking serious and effective action to improve hospital acquired infection rates."
Sir John Bourn, the comptroller and auditor-general, who wrote the NAO report, said lack of data, limited progress in the introduction of mandatory schemes to monitor infections and little evidence on interventions that might work were thwarting progress.
The current figures on Staphylococcus poisoning refer only to bloodstream infections, not those in wounds. These have often appeared after patients were discharged from hospital and were then poorly monitored.
GPs were prescribing antibiotics more prudently and patients were taking on board the need to complete courses of drugs, thus helping the battle against bacterial resistance to treatments. But there was no comparable information on the prescribing of antibiotics in hospital.
Mr Reid said the report and latest hospital records on MRSA infections were clear evidence that "some parts of the NHS have to do more to control this threat and match the achievements of hospitals which are able to maintain low MRSA rates".
The latest figures suggest that some of the most famous teaching hospitals have the worst rates of infection, although the figures should be treated with caution since those hospitals often deal with some of the sickest patients and conduct some of the most risky operations.
The Liberal Democrats criticised the shortage of isolation units, highlighted in the NAO report, and the fact that half of NHS trusts claim that flawed government targets on issues such as waiting times for hindering infection control are to blame.
The Lib Dem health spokesman, Paul Burstow, said: "Cutting infection is not rocket science. The NHS must relearn the lessons Florence Nightingale taught over 100 years ago."
The Tory spokesman, Andrew Lansley, criticised central government: "Thousands of lives may have been lost, yet the government's plans may amount to nothing. Hospitals need to be given real freedoms if hygiene levels are to improve, freedoms to introduce initiatives, improve facilities, and balance competing priorities such as waiting lists and safe bed occupancy levels, without risking the wrath of Whitehall."
The best ... and worst
MRSA infection rates in England (per 1,000 bed days)
General Acute
Worst: North Middlesex hospital NHS trust 0.33
Best: Hereford hospitals NHS trust 0.04
Single speciality
Worst: Cardiothoracic centre, Liverpool NHS trust 0.28
Best: Birmingham women's healthcare NHS trust 0.00
Moorfields eye hospital NHS trust, London 0.00
Speciality
Worst: Guy's and St Thomas's NHS trust, London 0.45
Best: Liverpool women's hospital NHS Trust 0.07
