Hospital managers should be regulated in a similar way to doctors and nurses, the senior doctor who first raised concerns about Lucy Letby has said.
Dr Stephen Brearey was the lead consultant on the neonatal unit where serial killer Letby worked and raised the alarm in October 2015.
He told BBC Radio 4's Today programme there was "no apparent accountability" for what NHS managers do in trusts.
Letby was handed a whole life sentence on Monday at Manchester Crown Court.
She murdered seven babies and attempted to murder six others in a neonatal unit at the Countess of Chester Hospital, in Cheshire.
The first five murders in all happened between June and October 2015 and - despite months of warnings - the final two were in June 2016.
In the BBC interview, Dr Brearey claimed senior staff at the Countess of Chester Hospital were worried about reputational damage to the organisation.
He said that instead of acting on his warnings he and his colleagues' lives were made very difficult - so much so that they felt under attack.
And he claimed his experience was not uncommon in the NHS.
The consultant added: "Doctors and nurses all have the regulatory bodies that we have to answer to, and quite often we'll see senior managers who have no apparent accountability for what they do in our trusts and then move to other trusts."
Dr Brearey said he worries about senior managers' future actions, adding that "there doesn't seem to be any system to make them accountable, and for them to justify their actions in a systematic way".
He also said he did not consider himself a whistleblower, but "I was simply trying to escalate concerns that all my colleagues shared, of a spike in mortality, an association with a member of staff, the unusual nature of these events, and the unusual timing of these events.
"We had reviewed all the cases on multiple occasions with an external expert and put all those concerns on paper and I felt really I was following a process rather than speaking out."
In a statement, an NHS spokesperson said: "It is absolutely vital that everyone working in the NHS feels they can raise concerns and that these are acted on and we have reminded NHS leaders about the importance of this following the verdict last week."
They added that every NHS trust is expected to adopt an updated Freedom To Speak Up policy, and ensure the information is easily accessible to staff.
On Friday, the government announced an independent inquiry into the events surrounding the Letby case.
Dr Brearey has said that given the "magnitude of the events that occurred" and the impact Letby's crimes have had on so many families, the inquiry should be judge led and have statutory powers - so witnesses can be forced to give evidence if needed. It is "clearly what the parents deserve," he added.
Currently, the inquiry that has been announced is non-statutory, meaning it has lesser powers.
Separately, calls are growing for the government to change the law to compel convicts to attend sentencing. Letby refused to turn up in the dock at Manchester Crown Court on Monday.
The judge proceeded without her and addressed her as if she were in the dock.
Letby was given multiple whole-life terms - one for each offence - becoming only the fourth woman in UK history to receive the sentence of whole life order. The trial lasted for more than 10 months and is believed to be the longest murder trial in the UK.
Prime Minister Rishi Sunak said it was "cowardly that people who commit such horrendous crimes do not face their victims".
BBC Panorama and BBC News investigated how Letby was able to murder and harm so many babies for so long. The 33-year-old deliberately injected babies with air, force fed others milk and poisoned two of the infants with insulin.
The BBC investigation found that the hospital's top manager demanded the doctors write an apology to Letby and told them to stop making allegations against her.
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2023-08-22 06:36:30Z
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