But NHS Tayside’s deputy chief executive Gerry Marr says that is “not realistic” in a busy hospital where there is a huge and increasing demand for treatment.

He says people who need to be in hospital getting treatment can’t be left at home without treatment just because they might get an infection in hospital.

Bed spacing and the link to the spread of infection was raised in NHS Tayside’s recent inspection by the newly established Healthcare Environment Inspectorate.

They recommended NHS Tayside conducted a risk assessment “to measure the need for a reduction in bed numbers within wards”.

The inspectors visited six wards at Ninewells, including Ward 31, at a time when that ward had just experienced the deaths of five elderly patients with Clostridium difficile.

In the immediate aftermath of the C.diff crisis on the ward at the end of last year, the number of beds on the ward was reduced by five.

Most wards at Ninewells are made up of four communal bed bays, usually with six beds in each bay, and a limited number of single rooms.

“Over the next five years, we are going to try to create more single-room accommodation and reduce the number of beds in a bay from six to four, as the opportunity arises to allow us to do that,” said Mr Marr.

That had already happened on one ward at Ninewells following a major refurbishment, and prior to the Ward 31 action.

Mr Marr said there was “good evidence” that increasing the space between beds reduced the risk of cross infection, but, taking out beds reduced the amount of “activity” on the ward — in other words, fewer patients could be treated.

“You are taking down the level of intensity on the ward and that is good infection control — we know that — but you have got to balance the risk of a patient acquiring an infection in hospital which is an identified risk, and we are doing everything we can to prevent that, against them not coming in to hospital at all for treatment,” said Mr Marr.

“So, if you have a very frail patient at home with pneumonia and other health problems, that is going to require an intensive period of treatment involving antibiotics.

“We know that raises the risk of acquiring an infection while they are in hospital, but not bringing them in is just unthinkable.”

Mr Marr said the HEI inspectors had made no specific requirement for bed reductions.

“Everyone recognises you can’t just turn the tap off and reduce the numbers in six months,” said Mr Marr.

“It’s a big hospital. It’s busy. We need the beds because we need to treat people.

“If we were dealing with infection and only infection we’d look to reduce our beds by 100, but we need to balance that against the need to have sufficient beds to care for people, so it is unlikely we would be seeking to reduce our bed base by that number.”