NHS chief executive Sir David Nicholson has admitted personal failings over the Mid Staffordshire scandal but declared he was "absolutely" the right person to lead the NHS and would not resign.
Despite continuing calls for his resignation following the publishing of Robert Francis's report into the failings at Mid Staffordshire NHS Foundation Trust, Nicholson said he would remain in his role as the NHS is at "maximum risk" as it undergoes reform.
Nicholson was facing questions from MPs on the health select committee about his handling of the Mid Staffordshire scandal, in which up to 1,200 people died at the hospital between 2005 and 2009 and many more experienced "appalling and unnecessary suffering" because of management failings.
Nicholson was head of the strategic health authority that oversaw the hospital in 2005. He claimed he had "no idea" of the mortality rates at the hospital, but denied he had turned a blind eye.
He admitted to MPs that when he oversaw the hospital, the patients had not been the "centre of the way the system operated" as those in charge had put finances and targets before care of patients.
Nicholson told committee members: "For a whole variety of reasons, not because people were bad but because there were a whole set of changes going on and a whole set of things we were being held accountable for from the centre, which created an environment where the leadership of the NHS lost its focus - and I will put my hands up to that - I was part of that.
"In a sense my learning through all of that is never to let it happen again."
Incentivising the NHS
Despite demands for his resignation by the families of those who died and other campaigners, Nicholson was backed by the NHS Board, Prime Minister David Cameron and health secretary Jeremy Hunt.
"At the moment the NHS is facing its greatest challenge," Nicholson said.
"In the next few days we will abolish over 160 organisations and we will set up another 211 local organisations and a whole myriad of national ones. We'll completely change the way in which we allocate resources and incentivise the NHS.
"At the same time, we have already lost 13,500 administrative and management staff that have all that corporate memory in them.
"So it is at maximum risk over the next few days.
"I said two years ago that I would take the responsibility of leading the NHS through this enormously complex set of changes.
"I promised both the government and the NHS that I would see that through and I am absolutely determined to do that over the next period.
He added: "Given my commitment to the [NHS] constitution, given my understanding of the way the NHS operates, given my commitment to patients and the way I conceive things like transparency and opening up the NHS, I think I am absolutely the right person to take that forward."
A spokesman for Cameron said Nicholson had done "a very good job" as NHS chief and had "properly apologised for mistakes".