Evidence this week of widespread massaging of financial results makes alarming reading.
According to the Chartered Institute of Management Accountants, many NHS finance directors are under intense pressure to mask deficits and forecast what people want to hear.
Discrepancies of half a million pounds between forecast and result are common.
This week's final article in our series on turnaround trusts highlights that pulling a service back from the abyss requires honesty about the problems, built on the foundation of robust data.
Massaging figures is a short-term palliative that will only exacerbate underlying weaknesses, and it is alarming for CIMA to be claiming that such a culture is widespread.
Finance directors report to many powerful players: the chief executive, trust board, strategic health authority and the NHS centrally.
The financial crisis from which the NHS is emerging, so damaging to the service's reputation, is irrefutable evidence that chief executives and others must encourage openness and transparency in financial reporting, and that finance directors must fight their corner against those who can only cope with good news.