Tory plans to fine hospitals if patients fall prey to superbugs like MRSA or clostridium difficile could lead to the fabrication of data by NHS staff, according to a Midland health expert.

David Cameron spoke out during a visit to Trafford General Hospital in Manchester yesterday, claiming "money should attend success, not failure."

But Professor Chris Ham, based at Birmingham University's Health Services Management Centre, argued that clinicians may be "reluctant to record accurately and honestly when cases of MRSA and C.diff occur".

"We're only going to make progress in providing quality patient care if we record when these outbreaks happen so we can look at trends to learn how we can improve infection control," said Prof Ham.

"If you start fining hospitals over superbug rates, then staff and clinicians may be more reluctant to record accurately and honestly when cases of MRSA and C.diff occur.

"The main issue around hospital acquired infections is to realise it is a problem that needs to be tackled, which is why better recording of cases and analysing in detail why they occur is essential."

He added: "I'm not worried about whether this will be extended to other areas of health-care, as issues around MRSA and C.diff are ultimately linked to patient safety, and

inaccurate recording of cases could compromise that." Mr Cameron told hospital staff that he wanted to use the NHS's 60th anniversary to reinforce the Conservatives' commitment to it.

He said: "We will ensure that hospitals and clinics and other care providers are paid according to the results they achieve."

However he denied this would pit parts of the NHS against each other.

"It should be a basic rule of social policy that you don't pay for what you don't want more of. Money should attend success, not failure.

"So, for instance, I don't think hospitals should be paid - or paid in full - for a treatment which leaves the patient with a hospital-acquired infection like MRSA.

"So-called 'treatment following adverse events' should be the responsibility of the provider, not the purchaser - the hospital, not the GP or primary care commissioner. This is a means of hard-wiring infection control into the system. Rather than a top-down system of targets which encourages 'throughput' above all else, we propose a bottom-up system which prioritises quality as well as quantity."

But Health Secretary Alan Johnson claimed he was proposing something that was already in legislation before Parliament.

"The Tories have no new ideas for tackling hospital associated infections. We are already taking powers to fine poor performing hospitals, with the pledge to reinvest that money back into the local NHS," he said. "But worse than that is the Tory plan to scrap Labour's rigorous targets to reduce hospital-associated infections. Under David Cameron the NHS would be encouraged to take its eye off the ball when it comes to fighting infection."

Last year Prime Minister Gordon Brown ordered all hospitals to carry out 'deep cleans' before the end of March.

Hospital trusts across Birmingham have reported to Coun Deirdre Alden (Con, Edgbaston), chair of the city's health overview and scrutiny committee, on their deep clean initiatives and the costs being incurred.

But two of the city's biggest acute trusts - Heart of England Foundation Trust and University Hospital Birmingham NHS Foundation Trust - have warned the watchdog they are unlikely to meet that deadline.

Heart of England - which runs Good Hope, Heartlands and Solihull hospitals - will clean all non-clinical areas, with its ward deep clean set to recommence "in February/March 2008" once winter pressures have eased.

University Hospitals Birmingham NHS Foundation Trust, which runs the Queen Elizabeth and Selly Oak hospitals, will take a week to clean each of the 43 wards across the sites, which is set to be completed by December.