Under-fire NHS boss Sir David Nicholson says he is “absolutely determined” to stay in his job despite admitting failures over the Stafford Hospital scandal.
Sir David said the “NHS lost its focus” and he conceded that he “was a part of that”.
But he again rebuffed calls for him to resign, saying he wanted to lead the NHS through coming health reforms.
Campaigners said that Sir David should be sacked following the publication of the Francis Report into serious failings at Mid Staffordshire NHS Foundation Trust.
He was in charge of the regional health authority for 10 months between 2005 and 2006 - the height of the failings in care at the trust.
Giving evidence to the health select committee, Sir David said: “During that period, across the NHS as a whole, patients were not the centre of the way the system operated.
“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.
“I put my hands up to that and I was a part of that, but my learning from that was to make sure it doesn’t happen again.”
But he told MPs that the local health authority had “no idea” about the serious care failures at the trust - where patients were routinely neglected and as many as 1,200 could have died needlessly as a result of maltreatment and neglect.
Patients were left lying in their own urine and excrement for days, forced to drink water from vases or given the wrong medication.
“We had no idea,” he said.
“The information was not bought to the strategic health authority, we did not see any of the information which would lead you to believe that there was all of this going on in Mid Staffordshire.”
Sir David added that he visited the hospital during the time when problems were emerging but was not alerted to any cases of neglect and poor care. He also said that the regional health authority was not alerted to high mortality rates at the trust.
“I had not come across hospital standardised mortality rates during my period at Shropshire and Staffordshire nor before that,” he told the cross-party committee.
“I did not have access to that information. At that moment in time, surprising as it may seem in retrospect, it was not part of the regular way in which NHS organisations were monitored in the NHS.”
During the hearing, committee member Valerie Vaz told him: “Please don’t feel that this is a trial.”
She then launched into a tough examination of his time as chief of the local health authority, telling him: “What struck me about your statement is it is very much like you are a process man and a procedure man. I can’t find anything about patients in there and what you are going to do on quality of care.”
Sir David rejected the description as “unfair”.
He said the system required accountability at hospital level, and many of those in charge of Mid-Staffs - including the chairman, non-executive directors, finance director, corporate affairs director and medical director - had all gone as a result of the scandal.
“It is not true to say that people weren’t held to account in the NHS. They were,” Sir David said.
“My accountability was very different from that, in the sense that I was held to account for delivering the change, for delivering three SHAs into one, for moving 70 primary care trusts into about 40, for making sure that all the organisations delivered what was regarded as the must-be-dones, which is essentially access and MRSA and C-diff reduction.
“That was narrow, and I accept that that was a narrow definition of accountability, but that was the way it worked.
“It shows in Mid Staffordshire, that that was a big failing in the whole system and I was in that system and I was part of it, absolutely.”
At the time, he was responsible for three strategic health authorities, and hospital trusts like Mid-Staffordshire were each statutory bodies with their own responsibilities for what went on within their hospitals, he said.
Sir David said the health service is currently at “maximum risk” as controversial changes are implemented throughout the country.
“At the moment the NHS is facing its greatest challenge,” he 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.”
The NHS boss has been backed by the prime minister and a number of former health secretaries.
But Julie Bailey, who set up the Cure The NHS campaign group after her mother Bella died at Stafford Hospital in 2007, said Sir David’s evidence was “shameful” and “embarrassing”.
After the hearing, Ms Bailey, who has led the calls for Sir David’s resignation, said: “That man is an absolute disgrace.”
Asked about suggestions that he would stay in post to lead reform of the NHS, she replied: “I think it’s just laughable. He is desperate to carry on in his job.
“We need to get rid of him. Nothing will change. He is part of the problem, not the solution.”
Prime Minister David Cameron said last month that Sir David was doing “a very good job” at the head of the NHS and should not be made a “scapegoat” for the failings at Mid-Staffordshire.
Following yesterday’s hearing, his official spokesman said that this remained the PM’s view, telling reporters: “He stands by his words.”