The investigation by The Independent and Channel 4 into the Northern Care Alliance NHS Foundation Trust is distressing enough in itself – and the lack of care shown to patients in need is plainly negligent, and quite possibly criminally so.

What is still more disturbing, however, is the widespread nature of the failings in basic care across multiple hospital departments, and also the lack of response from the regulators and other authorities when whistleblowers came forward to voice serious concerns.

There have been too many scandals in the NHS in recent decades, but most were confined to one area of care within a trust, notably maternity services, or one particularly incompetent practitioner, such as a surgeon. What seems to have happened with the Northern Care Alliance NHS Foundation Trust is that an organisation entrusted with the care of more than a million patients across Greater Manchester has suffered a series of endemic failures.

There are numerous individual cases, involving deaths during surgery not followed up by proper analysis of what happened, and why; cancer diagnoses delayed; patients left in pain and in corridors; and others having to have avoidable invasive procedures, including kidney dialysis.

A particularly horrific set of allegations concerns the work of a “rogue” spinal surgeon, John Bradley Williamson, who harmed dozens of patients at the trust between 2009 and 2014, including some who received misplaced screws, causing chronic pain.

The multiple failings around the NHS in Greater Manchester were also unforgivably compounded by what appears to be a general lack of supervision by trust management and regulators. Some trust staff claim they were encouraged not to submit reports to managers when safety issues arose, while others say their accounts of serious harm and death were shut down or not investigated properly.

In terms of the widespread breakdown in standards, this scandal is only rivalled by events at the notorious Mid Staffordshire NHS Foundation Trust two decades ago – and, in terms of the numbers of patients involved, may well exceed any comparable set of incidents in the past.

Such widespread failings often derive from cultural factors – a sort of collective forgetfulness of the central function of a hospital: patient care, rather than hitting targets or achieving financial parameters. This is then made worse by the natural instinct of most institutions towards self-preservation, leading to cover-ups and deception.

This tendency applies as much to political parties, charities and religions as it does to banks, companies and government agencies. (The behaviour of the social media giants is a topical example of this.) The challenge is to ensure that there are strong incentives to detect and correct malpractice and shortcomings, and sufficiently close supervision to do so.

In this respect, the legal protections for the whistleblowers at the Northern Care Alliance NHS Foundation Trust were not robust enough, and that is probably also the case elsewhere. It would also be interesting to hear from the Care Quality Commission (CQC) as to what, if anything, they saw or heard about the poor performance of the various arms of the NHS in Greater Manchester.

Not so very long ago, then health secretary Wes Streeting declared that the CQC was not fit for purpose, and the later report by Dr Penny Dash, a senior clinician and NHS executive, has confirmed that was indeed the case. Whether the abolition of NHS England and folding its activities back into the Department of Health and Social Care will improve oversight and patient welfare is not clear.

While not one of his direct responsibilities, it would also seem from our investigation that the office of Andy Burnham, when mayor of Greater Manchester, was informed that whistleblowers had been “bullied into life-altering illnesses, early retirement or a fearful silence”, among other concerns. It has an unhappy echo of when he was health secretary in 2009 and had to deal with the fallout from the Mid Staffs crisis. Once again, Mr Burnham finds he has some unexpected questions to answer.

Patients have rights, in the colloquial sense of the term; but few are protected by statute, and too often they are not safeguarded by the medical professionals and managers who should know better. Appalling as the scandals of recent years are, they do represent a relatively small proportion of the total work of the NHS, where patient satisfaction is often high and the treatment world-class.

But the scandals are too many in number and too persistent for things to be allowed to run on as they have been. It is, as ever, a matter of resources but also one of culture – and one of legally enforceable minimum rights for patients, even if that is within the context of a service that has waiting lists, “corridor care” and insufficient staff. The scandals need to stop.