This paper examines the experiences of a publicly owned hospital which had formerly been part of a religious order of nuns. This paper presents novel findings to extend our understanding of the emergent theory of transparency in the public sector. The literature on secrecy and transparency is drawn upon to inform a case study investigation of the use of accounting under both forms of ownership. This reveals both the continuing influence of this hospital`s prior existence and the difficulties of adapting to public ownership. The findings reveal the tensions of the change from secretive religious organisation and history of parsimony to current public sector organisation. The end state of public sector ownership brings its own difficulties, with accounting systems failing to achieve the aim of transparency. Keywords: charity; religious secrecy; public ownership; transparency; health care.