Published: 11/08/2005, Volume II5, No. 5967 Page 10

There are only a few things in this world that are generally accepted to be beyond criticism. Like dolphins and Nelson Mandela, British hospitals fall into this category - in the mainstream media at least.

It seems that the caring, philanthropic image of the hospital must not be tarnished, lest society crumble at the idea that they are staffed by normal human beings open to the same temptations as the rest of us, rather than the higher, noble creatures of popular perception.

In medialand, if something goes wrong at the local hospital it is almost always entirely the fault of someone - or something - else. It may be government policy, 'health service bosses' at the strategic health authority or dastardly commissioners at the primary care trust.

Or sometimes the blame must fall on evil, pen-pushing managers at the acute trust itself who are on a personal vendetta to destroy the much-loved institution.

And so it was, equipped with the media manual on who is always good and who is despicably bad, that BBC R4's File on Four approached its analysis of payment by results, aired last Tuesday.

Foundation trust chief executives got away with praising their coders, almost admitting that clever numbers work was making the trust more money. They hit out at dastardly PCT managers for querying their bills, and PCT representatives were given a grilling of the highest order.

But when the NHS Alliance's Mike Sobanja spoke of dodgy coding at foundation trusts, he was vehemently attacked by the reporter.

It is a bit unfair to blame a skewed report entirely on media stereotyping. Perhaps NHS commissioners need to rethink their communications with investigative journalists.

If they were to give facts and figures, say, rather than a bland joint statement or blunt refusal to comment, it might be possible to start redressing the balance.