NHS chief Sir David Nicholson remains in his role today despite calls for him to resign over the Stafford Hospital scandal.
Victims' families have demanded he step down, but Sir David said he is "not ashamed" of being in his job following the publication of the Francis Report.
It highlighted the "appalling and unnecessary suffering" of patients at Mid Staffordshire NHS Foundation Trust between 2005 and 2009.
Sir David, who was chief executive of the West Midlands Strategic Health Authority (WMSHA) between August 2005 and April 2006, told ITV News: "I am not ashamed of being in my job today.
"Clearly it was a whole system failure and we need to reflect on what Francis says, the whole of the NHS - myself, leaders in the NHS, doctors and nurses - need to reflect on what we can learn from that to make sure it never happens again."