Only one NHS worker in Scotland has been disciplined for not washing their hands as part of the battle against hospital superbugs in the last three years.
NHS Borders is the only health board to take a staff member to task, even though cases of infections such as Clostridium difficile (C.diff), norovirus and flu remain high in hospitals across the country.
Health bosses and the Scottish Government has suggested in the past that disciplinary action may be the only way to get through to those who repeatedly ignore warnings.
Conservative health spokesman Jackson Carlaw said it appeared there was no deterrent to stop people from failing to wash their hands, given a national hand-hygiene monitoring scheme was scrapped in September.
An audit showed only 91% of doctors complied with the National Hand Hygiene Audit between November 19 and 30, 2012.
The same report showed only 88% of NHS Grampian staff complied with the measures – the worst rate in Scotland.
But recently released figures showed the number of cases of C.diff among those aged 65 and over in the board area had plummeted from 953 in 2008 to 96 in 2012 – an 89% reduction.
In the NHS Highland area, the number of outbreaks fell from 150 in 2008 to 57 in 2012 – down 62%.
Mr Carlaw said: “This is a critically important matter – but it seems neither health boards nor the Scottish Government are taking it sufficiently seriously.” A spokeswoman for NHS Highland said hand hygiene training was given to all new recruits and every hospital ward carried out a monthly audit programme. “Anyone failing to comply with hand hygiene is spoken to at the time and reminded of their responsibility,” she added.
“We find this to be a successful way of ensuring that all staff adhere to hand hygiene.”
A spokeswoman for NHS Grampian said good hand hygiene was a matter of education and support, not discipline, and all staff were committed to meeting high standards.