The focus on hand hygiene appears timely, given the problems that we have with transmission of infection in our hospitals. Unfortunately, people do not always clean their hands when they should, and even if they do, there are other factors that contribute to the acquisition of infection. Nonadherence to hand hygiene is now being targeted by the introduction of more rigorous assessment in healthcare environments. “Zero tolerance” mandates are facilitating managerial pursuit of poor hand hygiene, with a variety of disciplinary outcomes. This article questions the priority afforded hand hygiene and its enforcement and asks whether we should reconsider additional infection control strategies rather than threaten staff over hand hygiene practices.