What the latest scandal says about the NHS
News that a hospital has been tampering with patient records to improve its waiting times for cancer treatment, potentially putting patients at risk, is truly shocking.
The issue is so serious that the police has been asked to investigate Colchester General Hospital.
Such a situation is unprecedented in the NHS - and as a result the temptation is to dismiss it as a one-off that should be seen in isolation.
Unfortunately, it would be complacent to do so.
What this case demonstrates is the problem inspectors have in identifying some issues in organisations as complex as hospitals.
The Care Quality Commission did not find the dodgy records. It was told where to look.
During the spring Colchester was subject to an inspection as part of the Keogh Review into mortality rates.
The review - launched after the Stafford Hospital public inquiry - investigated the 14 trusts with the highest death rates.
Problems were identified, including with the ways complaints were handled, staffing rates and leadership weaknesses, but not this.
The concerns that were identified were not even considered important enough for Colchester to be placed in special measures.
When the results of the review were announced Colchester was one of only three trusts that escaped the sanction.
But towards the end of the Keogh process a whistleblower raised concerns about the tampering of records.
This was passed on to the CQC which carried out its own inspections in August and September.
These led to Tuesday's report that showed different information was being entered into the hospital's system than was on the patients' notes so their cancer performance data looked better than it was.
The trust has now been placed in special measures and the management of the trust is being reviewed.
But to make matters worse, the trust had also carried out its own probe in early 2012 after concerns were raised by admin staff in the cancer department.
It did not identify serious problems, but the trust now accepts the issue was "not properly investigated".
The fact that concerns had been aired but not properly looked into has chilling echoes of the Stafford Hospital scandal.
Christina McAnea, head of health at Unison, whose members raised the alarm, says: "They raised their concerns repeatedly and in emails to senior managers, right up to the chief executive, but they were ignored."
Last week a review of complaints by the Labour MP Ann Clywd said the culture of "delay and denial" had to end.
The Colchester case shows just how far the NHS has to go.