A senior civil servant has told Newfoundland and Labrador's breast cancer inquiry he assumed Premier Danny Williams would be informed about lab testing problems in July 2005.
Robert Thompson was the clerk of executive council on July 19, 2005, when he was alerted to what he described that day as a "major" public health issue involving as many as 1,500 breast cancer patients.
Thompson immediately contacted the chief of staff at the premier's office, although a few hours later Thompson received an e-mail from the Department of Health's communications director advising that no action was required.
Thompson began testifying Wednesday at the Cameron inquiry about that exchange of e-mails, which had been already been entered into evidence.
'Deserves to be known about'
Asked by inquiry co-counsel Bern Coffey if he expected that Brian Crawley, the chief of staff in the premier's office, would bring the first e-mail to Williams's attention, Thompson said yes.
"I expect that he would consider that and, depending upon the premier's availability and Brian's perceived understanding of whatever else was on the premier's agenda that day and the timing available to him to do it, that, yes, he would make him aware of this," Thompson told the inquiry.
"It's the kind of issue that deserves to be known about."
Williams has said he was not told about the problems with hormone receptor tests until the matter became public in the fall of 2005.
Eastern Health, the regional authority that managed the lab, had intended to notify patients, but not until the testing was complete.
However, the testing process turned out to take much longer than expected, and the inquiry has been repeatedly told that Eastern Health had difficulty contacting patients.
Little recollection from early days
Thompson, who is now the secretary to cabinet on health issues and the chairman of a task force on adverse health events, also told the inquiry that he cannot remember much beyond the original e-mails of July 2005.
"I have no additional recollection, unfortunately, about any discussions that I might have had or not had about these e-mails or about that event at that time," Thompson said.
"I can't. I've tried hard, because it's clearly an obvious question, but I just don't know what happened next."
Coffey pressed further on the issue.
"Do you have any reason to believe that there's any official in cabinet secretariat who has any actual memory of this or purports to have any actual memory of what happened?" Coffey asked.
"No," Thompson said. "I know that no one does because I've asked them all."
Questions lack of documentation
Coffey asked Thompson whether he thought it was "satisfactory" that there is no record in the cabinet secretariat from July 2005 other than those initial e-mails.
"We do know that things changed course as a result of the July 21st briefing," said Thompson, referring to a meeting between government and Eastern Health officials, during which then health minister John Ottenheimer urged public disclosure on retesting of cancer samples, but was persuaded not to do so by Eastern Health medical staff.
"I understand your question," Thompson said, "but it's important to place it in its full context that while there may be nothing that's on the documentary record, it doesn't mean that the officials involved, all of whom are highly capable individuals and have a good sense of how to manage issues, didn't take the right steps at that time."
Justice Margaret Cameron has been hearing evidence since March on what went wrong with hormone receptor testing between 1997 and 2005, and what officials did once the problems were recognized.
Hormone receptor tests are used to help determine whether a breast cancer patient can benefit from antihormonal therapy, like Tamoxifen, which is toxic but has been clinically shown to improve chances of survival.