Early e-mails convey urgency, then calm, over cancer testing woes

If e-mails could make noises, some messages sent around Confederation Building one morning in July 2005 would have sounded like alarm bells.

Within a matter of minutes, top-ranking officials notified each other — including several in the office of Premier Danny Williams — on the morning of July 19, 2005.

Later that day, the health minister at the time — John Ottenheimer, who has been testifying at a judicial inquiry on flawed testing for hundreds of breast cancer patients — would be first told about serious problems at a St. John's pathology lab.

The inquiry has also been told that within hours of those initial alarm-ringing messages, the premier's office was told that no action was required, in what Williams described on Monday as "a stand-down statement."

The issue has been an important focus of an inquiry headed by Justice Margaret Cameron, which in its early weeks has been looking at what and how much government officials and politicians knew about problems with Eastern Health's lab.

The inquiry's mandate is to look at why hundreds of breast cancer patients were excluded from therapies that may have helped them.

'Heads up' e-mail from official

The first e-mails distributed on July 19, 2005, certainly convey a sense of seriousness.

In the first, official Gary Cake writes to Robert Thompson, at the time the clerk of executive council and the provincial government's highest-ranking civil servant, with a "heads up that a major story will break" in the coming days.

Cake, who had been informed during a phone call from Ottenheimer's communications director, Carolyn Chaplin, told Thompson that "an estimated 1,200 to 1,500 clients will need to be retested," and that "legal advice is being engaged in this process." Cake wrote that the premier's communications director, Elizabeth Matthews, had also been advised.

Within minutes, Thompson wrote to Brian Crawley, the chief of staff in the premier's office, "This is major. Once the solution is set into motion, we will expect the department and the board to undertake appropriate evaluation to determine why this happened."

In a response to Cake minutes after that, Thompson wrote, "Please ensure the department and the board include in their com plan the assurance that once the solution is set into motion, that an evaluation will be done to determine the specific or systemic reasons why this occurred so that the matter will be properly addressed in the long term." Thompson added he wanted to see "this aspect" before it was distributed.

Later in the day, Ottenheimer was told about the hormone receptor testing problems during a meeting with George Tilley, who was the chief executive officer of Eastern Health. Ottenheimer has testified that he saw the problem as a pressing public health issue, and that he wanted to make the issue public as soon as possible.

That sentiment was reflected in an e-mail Tilley later sent to the board's chair, Joan Dawe, who has already testified.

'No action is required': Chaplin

But still later on July 19, 2005, the senior executive ranks of government were given a message with a very different tone.

In a message to Cake and copied to John Abbott, then the deputy minister of health, Chaplin wrote: "Further to this morning and incoming information this afternoon, no action is required at this time."

Chaplin wrote that a briefing was being arranged for later in the week. "No public announcement will be forthcoming this week and there is a possibility that the significance of any announcement will be minimized," wrote Chaplin, who did not explain what triggered the change in approach.

Ottenheimer testified Monday that he was never told about that particular e-mail, one of a series of e-mails and documents that was discovered only last week, causing a four-day delay at the inquiry.

"One would think I would be fully aware of the specifics and details of an email such as that," Ottenheimer told the inquiry.

Ottenheimer had previously testified that he met with Eastern Health officials on July 21, 2005, and that he was persuaded to follow their advice not to make public disclosures about problems with the lab, for fear of alerting patients.

Questioned in the house of assembly over the issue on Monday, Williams said he "absolutely, honestly, sincerely [had] no recollection and cannot remember any conversation on that particular matter."

Williams pointed to Chaplin's last e-mail on the matter. "So, in fact, there was a stand-down order, a stand-down statement, that came from the Department of Health that this issue was being dealt with internally," Williams told the legislature.

Meanwhile, the inquiry was presented with evidence Monday that indicates Eastern Health officials were in no hurry to tell the public about problems with the pathology lab.

Risk of public disclosure discussed

In a memo to Tilley on July 21, 2005, Eastern Health communications director Susan Bonnell advised Tilley of the risks of making the issue public.

"While I am a strong advocate of public disclosure … I'm not convinced that we can serve the 'greater good' and still maintain the reputation of the lab which, in my opinion, is in the best interests of the public to maintain."

Bonnell wrote that the issues raised are complex and difficult for the public to understand, and cautioned against holding a news conference. While efficient, she wrote, "reporters can adopt a mob mentality and the issue can be sidetracked in all the media by one stray comment or idea. Besides which, we do not plan to 'take blame' for something we did wrong so we do not need to line up the players as if we are taking blame."

In that memo, Bonnell recommended that Eastern Health work with patients directly, and not make a public announcement.

Story 'should be dead,' communications official wrote

Another exhibit presented to the inquiry Monday spoke to the way Eastern Health dealt with the media after problems with hormone receptor testing became public in October 2005.

In a Dec. 1, 2005, e-mail to a communications officer in the provincial health department, Eastern Health media relations officer Deborah Thomas-Pennell described how she had been dealing with queries from a CBC Radio reporter working on a story about delays in retesting at Mount Sinai Hospital in Toronto.

"I managed to hold him off until today," she wrote to Tansy Mundon. "That way, the issue should be dead by the time the house opens again next week."

Mundon relayed the e-mail to an aide to Ottenheimer with the note, "Please make sure the minister knows."

Last week, Ottenheimer told the inquiry that he would have answered questions in the fall of 2005 about hormone receptor testing, if only he had been asked.