The government's healthcare watchdog has told hospitals to improve maternity services in England after a survey found shortages of beds, dirty bathrooms and sparse consultant attendance on wards.

The Healthcare Commission said a survey of 26,000 mothers and 5,000 maternity staff had found a wide variation in the care offered by 150 National Health Service hospital trusts across the country.

Overall most women (89 percent) giving birth early in 2007 rated their experience as good.

But at the least well-rated hospitals just two-thirds of mothers thought their care during labour and birth was good or better, compared to 92 percent at the best units.

The Commission reviewed all maternity services in England after three investigations into deaths at maternity units which had found a number of shortcomings, including insufficient staff and poor communication with mothers.

After publication of the watchdog's preliminary results in January, the government announced an extra 330 million pounds of maternity funding over three years.

Now it was up to hospitals to play their part, and "seize the opportunity . to make lasting improvements for women," said Healthcare Commission Chairman Ian Kennedy.

"There is clearly more to be done to improve the quality of clinical care as well as the experiences of women. The matters raised and the views expressed must not be ignored."

In a report on Thursday, the Commission said many hospitals were short of delivery beds, using the same bed on average for two women during each 24-hour period.

"This seems excessive and there is clearly a need to increase the capacity of delivery beds in these units," it said.

Less than half (49 percent) the women surveyed said the toilets and bathrooms at their maternity units were "very clean". London hospitals were rated noticeably worse for cleanliness.

On staffing, the report said hospitals should urgently examine their level of obstetric consultant care.

It said at some hospitals consultants spent just 10 hours a week on labour wards, well below the recommended 40 hours (60 hours on large units).

The number of midwives per 1,000 births a year was as low as 23 in some trusts, and over 40 at others, compared to a median level of 31.

"Trusts employing numbers of staff that are well below the median should consider whether these levels are adequate," the report said.