Mrs Skinner spends considerable time visiting hospitals throughout the state, listening to concerns raised by staff, patients and their families before publicly voicing their grievances.

She visited Nepean Hospital last week and noted concerns related to understaffing at the Pialla Mental Health Unit, poor investment in infection control and problems in meeting the needs of emergency patients in a timely fashion.

Mrs Skinner said she had been advised the Pialla Unit was frequently short of nurses because rostered staff were regularly asked to provide cover for Blue Mountains Hospital, leaving behind a skeleton staff to deal with difficult patients in stressful and potentially dangerous conditions.

Ms Skinner also told the Star the temporary closure of the birthing unit at Blue Mountains District Anzac Memorial Hospital would put Nepean Hospital's maternity unit under considerable extra pressure.

She said routine monitoring of hot-water systems at Nepean Hospital in May showed a positive result for legionella bacteria affecting the hot-water supply in two wards.

``Infection control specialists advise that where infection spread is rife you will find a hospital under stress and this is certainly the case at Nepean,'' Mrs Skinner said.

``It's scandalous that Health Minister Reba Meagher does not record the rate of hospital-acquired infection in routine reports on adverse incidents.

``Patients have the right to know how a hospital performs before they make decisions about where they will be treated.''

A NSW Health and Sydney West Area Health Service (SWAHS) spokesperson said they were committed to consulting with staff to ensure the existence of safe work environments.

She said immediate measures were taken as soon as the positive legionella result was detected, including flushing of the water pipes and additional chlorine

dosing.

Dr Glenn Close, director of Population Health and Strategic Planning for SWAHS, said an expert review of the entire warm-water system in the south block of Nepean Hospital would also be undertaken.

When asked about the hospital's Pialla Unit, the spokesperson said it was staffed according to standards at the appropriate ratios of nursing staff per bed numbers on all shifts.

``This is set according to established reasonable workload standards and any additional staffing issues that arise are directed to an appropriate workload committee for resolution,'' she said.

``SWAHS has a grievance management policy that is actively used to manage any issues identified by staff .

``This ensures that appropriate outcomes are achieved.''

Ms Meagher's spokeswoman said her boss met doctors, nurses and frontline staff in hospitals across the state every week.

She said Ms Meagher had visited Nepean Hospital three times in the past year, most recently last month when she inspected enhancements made possible under the $1.34billion State Health Budget allocation for SWAHS.

The spokeswoman said SWAHS worked closely with all hospitals within the area to ensure staffing arrangements were appropriate and directed to where they were needed the most and cited the Iemma Government's $10million investment this financial year to enhance the SWAHS workforce.

She said a patient satisfaction survey released last month showed 86 per cent of patients in SWAHS rated their overall care as good, very good or excellent.