Robert Francis QC has defended his report against criticisms it failed to hold senior figures to account and contained too many recommendations.

The Report of the Mid Staffordshire Foundation Trust Public Inquiry, published in February, contained 290 recommendations but did not single out individuals for criticism over care failings at the trust, citing a desire not to create “scapegoats”.

Patient campaign group Cure the NHS and others have expressed disappointment Mr Francis chose not to criticise NHS chief executive Sir David Nicholson.

In his first major public appearance since publication of the report, Mr Francis said a public inquiry was “not the forum in which we can put someone on trial”.

“Had that approach been attempted this inquiry would have lasted longer than the Bloody Sunday inquiry, would have cost more and would not have achieved the learning points,” he added.

The Bloody Sunday inquiry into the actions of British soldiers during a particularly brutal day of violence in Northern Ireland lasted nearly 12 years. It cost more than £200m, compared to around £13m for the Mid Staffordshire public inquiry.

Mr Francis was speaking on Wednesday at a conference organised by health think tank the King’s Fund. His comments followed a question from the audience about whether Sir David should lose his job as a result of the scandal.

He added: “If you want to judge your leaders - everyone from the secretary of state to managers of cleaners in hospitals - the test should be how are they reflecting the lessons in this report [in what they do]… and putting in place changes. It’s on that I suggest you concentrate, rather than me taking a judgement on whether A or B should keep their job.”

In an earlier presentation to the conference, Mr Francis pointed out his report contained “on a chapter by chapter basis, explanations of what individuals did and didn’t do, and what was going through their minds at the time, and my assessment of that”.

In response to criticism from many senior NHS figures that there were too many recommendations he said: “It is tempting when faced with a disaster like this to do what’s happened before, which is to announce a full scale reorganisation. But we know that doesn’t work. I was asked to apply the lessons [from Mid Staffordshire] to the system as it is now… I have had a bit of a moving target.”

He urged those working in the NHS to get on and make the changes proposed.

“Why are you waiting? There is much that doesn’t require a change in law… It doesn’t require anything other than a change in attitude,” he said.