The chief executive of the NHS told MPs he will not step down over his role in the Staffordshire hospital scandal, which saw as many as 1,200 more patients die during 2005 and 2008 than would have been expected.
There have five reports into the scandal, which found that negligent care and excessive box ticking – valued over the care of patients - were to blame for the extra deaths.
Sir David, who became chief executive of the NHS in 2006 and will become the head of the new NHS Commissioning Board next month, lead the health authority responsible for the Staffordshire hospital for ten months between 2005 and 2006, at the height of the failings in care.
Appearing before the Health Select Committee on Tuesday he admitted to some faults, but said he would not be stepping down.
Sir David told the Committee: “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.”
He has faced repeated calls by MPs and the media to resign. Last month a public e-petition was launched calling for the NHS chief to resign. At time of press it had just under 5,000 people calling for him to step down; it must reach 100,000 signatories before it will be debated in Parliament.
The Committee’s hearing comes a month after the second Francis report on the Mid Staffordshire Trust’s failings was published, stating that the NHS culture was to blame and needed to re-focus on patients in order to avoid another Staffordshire-like scandal.
But Robert Francis QC, who wrote the report, fell short of placing blame on any individuals, including Nicholson.
'Narrow' focus on targets
Sir David also told the Committee that the key issues health authorities were focusing on during his tenure was access targets, such as the A&E four-hour waiting time target, and hospital infections, such as MRSA, and the reorganisation of structures.
“That was narrow, and I accept that that was a narrow definition of accountability, but that was the way it worked,” Sir David added. “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.”
The health secretary Jeremy Hunt publically backed Nicholson this week, saying he should remain in his job. This may be politically motivated, however, as the NHS reforms enacted by the current government hinge on the NHS Commissioning Board, which will take control of the £105 billion NHS budget in April.
If Nicholson was removed from his post as chief executive of the Board this late in the day, it could de-stabilise the reform agenda, causing political headaches in what is already a sensitive area.