Eastern Health should have dealt with cancer tests alone: former deputy minister

Newfoundland and Labrador's former deputy minister of health has testified Eastern Health made matters worse by involving the provincial government from the start of an unfolding cancer testing crisis.

John Abbott told the Cameron inquiry, which is examining how hundreds of breast cancer patients received inaccurate results of hormone receptor tests, that Eastern Health ought to have dealt with its lab issues without engaging the provincial Health Department so soon.

Abbott was deputy minister of health in July 2005, when Eastern Health realized it had serious problems with its hormone receptor testing program. At that point, the authority was beginning to have samples retested in Toronto, and would not know for several months that error-plagued testing stretched between 1997 and 2005.

Abbott said it was a mistake for Eastern Health to have brought the Health Department into the process while it was still figuring out its problems, and that doing so created confusion.

"This was and still is, in my mind, a significant operational issue that is left and should be left in the health authority's hands to address, resolve and communicate," Abbott told Justice Margaret Cameron.

"As we've seen, it got murky, at best, and consequently the lines [were] blurred."

The inquiry has already been told about a flurry of e-mails and phone calls around government offices in July 2005, when officials first learned of the lab problems.

Senior officials, including several in the cabinet secretariat and the premier's office, were told of a pending announcement involving the lab early on July 18, 2005. However, Carolyn Chaplin, the Health Department's communications director, wrote an e-mail within a few hours advising that no immediate action was required.

Abbott told the inquiry he was not involved in the decision to alert anyone else in government, and said it was too early to tell anyone anything.

"I was nowhere near knowing what the issue was to talk to anyone or inform anyone, and that would be true right across the board," Abbott told the inquiry.

Commission co-counsel Bern Coffey told Abbott that he has reason to believe Chaplin will tell the commission that Chaplin's e-mail — which Premier Danny Williams, who was notified at the time, last month described as a "stand down" advisory — was written with Abbott's direction.

Abbott said he could not recall doing so.

"It is very possible that we may have had a conversation in which I said, 'Well, let's wait until we get the information,'" he said.

"But I really can't explain it any more than that."

Minister 'comfortable' after being advised to wait

John Ottenheimer, who was the health minister at the time, has told the inquiry that he wanted to make the issue public as soon as possible, but was persuaded to wait, based on what he called professional medical advice.

"He was comfortable with the advice he was given," Abbott said.

"In saying that, he was assuming and working on the premise that this was going to be imminent, not weeks and months down the road."

In fact, nothing was ever said publicly about the issue until early October 2005, when the Independent, a weekly newspaper in St. John's, first reported on the retesting, which even then would take many more months to complete.

Abbott, who resigned as deputy minister of health last summer, soon after the government called the inquiry, is expected to continue his testimony on Friday.

Cameron's inquiry is assessing how an Eastern Health lab handled estrogen receptor and progesterone receptor tests, which are used to help determine the best course of treatment.

Scores of patients were wrongfully excluded from being considered for Tamoxifen, a potent but clinically effective antihormonal treatment that — especially when prescribed within a window of opportunity — can improve a patient's chances of survival.