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What's going on?

Head of the NHS Sir David Nicholson today faced the Health Select Committee to defend his record over the appalling treatment and subsequent death of patients admitted to Stafford hospital in 2005/6.

Nicholson, who has been facing calls for his resignation over the scandal, told the Health Select Committee that he was deeply saddened by reading the stories of patients who had been mistreated.

But he insisted that during the period when he was running the health authority responsible for Mid Staffordshire trust he did not have the information that would have allowed him to spot problems.

Is Nicholson's reputation sufficiently in tact to carry on with the job? Or should he stand down?

Case for: Responsible

Nicholson can only shy away from responsibility for so long. Put simply, the buck stops with him. Patients were put through unimaginable and often fatal suffering as part of a culture of target-chasing that put numbers first and people a long-distant second. The idea that he was far enough removed from Mid-Staffs to be absolved of shame is a chimera, and contadicted in part by a letter he sent congratulating staff for meeting targets in 2005, after a ward tour. He should send another letter now, to the public. Explaining why had no option but to resign.

Case against: Devolved

This is not one man's scandal. Forcing Nicholson to fall on his sword would give the illusion of closure when what's needed is root-and-branch reform. There were many individuals - managers and doctors alike - whose guilt far, far exceeds any that can be attributed to Nicholson. Furthermore, the pressure on him to reduce waiting times and chase targets came from above. It's terrible that our health service sunk to such lows. Nicholson is widely held a good and caring man, his departure would only impede reform.