Many hospitals use private cleaning firms
Nurses have called for hospital cleaning to be brought back in-house to tackle hospital infections.
The Royal College of Nursing conference overwhelmingly voted for a motion proposing an end to contracting out cleaning to private firms.
Cleaning contracts have been outsourced since the 1980s and about 40% of hospitals now use the private sector.
Nurses at the Bournemouth conference said it had led to a drop in standards and a rise in infections.
The government has made cleaning one of its highest priorities to tackle infections such as MRSA and Clostridium difficile.
It recently oversaw a deep cleaning programme of all hospitals in England and its infection strategy published in January said good quality cleaning was essential.
MRSA rates have been falling since early 2006 with the NHS on course to halve the number of infections this year based on a 2004 baseline.
But nurses still maintained infections was a pressing issue that was not being helped by the contracting out of cleaning, something which has been particularly popular in England.
No public sector ethos
May McCreaddie, a nurse from Glasgow, said: "There has been an increase in hospital infections and decline in cleanliness. It is quite simple."
She said private cleaning firms did not have the public sector ethos of in-house teams and there was higher staff turnover which contributed to poorer performance.
"We know what works we have been there before, we have had them. They are called ward domestics, they are an integral part of the team."
Sheila Dunbar, a nurse from Liverpool, added: "The increase in hospital infections is a big issue. NHS trusts in north west England have started to come back in-house to have cleaner wards."
But Derek Blackshaw, from Salisbury, said as well as bringing cleaning back in-house, it was important nurses on the wards were given responsibility for overseeing cleaning.
"It is not enough to bring it back in-house if you still need to deal with a chain of authority."
The delegates also heard from a number of nurses who described how in-house cleaners were much more part of the NHS family.
Dominic Walsh, a nurse from London who works on an intensive care ward, said he was proud to work on a ward where the cleaners employed by the hospital.
"I can say to Monica and Arnie 'you are coming to our Christmas party aren't you? You're an essential part of our team'."
Private sector defence
Andrew Large, the director general of the Cleaning and Support Services Association, which represents private cleaning firms, said the vote "flew in the face of the reality of hospital cleaining today".
He said: "Without contract cleaning, UK hospitals would be in a lot worse state than they currently are."
Mark Fox, of the Business Services Association, said: "There is no evidence to suggest that outsourcing cleaning services causes increased rates of infection.
"Indeed the private sector has led the way in developing new and innovative technologies to ensure the highest standards of cleaning."
A Department of Health spokesperson said: "Ensuring that hospitals are clean and safe is not as simple as bringing all cleaning in-house.
"There is no evidence of a difference in quality or in infection rates between hospitals that have in-house or out-sourced cleaning.
"It is more important to ensure that a culture of cleanliness is embedded at all levels in a trust, and every trust should have a 'champion' to represent cleaning-related issues at board-level."
In a later debate, nurses called on their union to lobby ministers over the provision of fertility treatment.
NHS guidelines in England and Wales recommend that patients be offered three cycles of IVF, but research has suggested many areas struggle to fund that many.
Jane Denton, of the RCN's Fertility Nurses Group, said that the battle patients faced to get treatment just "added to the pain" of struggling to conceive.