A senior executive of Newfoundland and Labrador's largest health authority has told a courtroom that Eastern Health is having a hard time following its internal policies, years after a forced merger of institutions.

Eastern Health is asking Newfoundland Supreme Court to rule that reviews by two external experts be kept secret when a commission begins hearings next month on flawed lab work involving hundreds of breast cancer patients.

Vice-president Oscar Howell told a court hearing that Eastern Health still does not have a written policy on quality assurance.
(CBC)

Lawyers for the commission, though, want the reports made public, and say Eastern Health didn't even follow its own peer review rules when experts from B.C. and Ontario reviewed the authority's lab.

Wednesday's testimony in St. John's put the focus on the aftermath of the provincial government's decision to collapse 14 hospital, nursing home and community health boards to four large boards.

Eastern Health was formed out of seven boards and covers about half of the province's population.

""We are still struggling, It's an enormous challenge," Oscar Howell, a vice-president of Eastern Health, told the court.

Howell, who was not in the position when Eastern Health revealed in 2005 that its lab had been producing hundreds of false results in hormone receptor tests, putting many cancer patients at potential risk, said many institutions are "still operating under old policies."

He also said that Eastern Health's quality assurance program did not have enough staff, and that Eastern Health is still writing a comprehensive quality assurance policy.

Eastern Health has argued in court documents that releasing the reports would violate confidentiality that was given to external reviewers.

Minnie Hoyles, a breast cancer patient who has enrolled in a pending class action lawsuit, found Wednesday's court proceeding difficult to hear.

"That kind of shocks me, because from what I understand our health care budget has increased by [about] $1.5 billion," Howell said.

"I'm beginning to wonder if there'll ever be enough money for health care, and where is the money actually going?"

Release all information: cancer society

Emma Housser, who works with the Canadian Cancer Society, one of seven groups that has intervener status in the court hearing, would not comment on Howell's remarks.

Instead, she said it's imperative for the Supreme Court to force Eastern Health to release all information it has about what went wrong at the St. John's lab.

"We feel that this information is relevant and would help to further the goals of the public inquiry [in] ultimately determining what happened," Housser said.

The commission, headed by Justice Margaret Cameron of the Newfoundland Supreme Court of Appeal, was appointed last year after documents filed with the class action lawsuit showed that Eastern Health had been aware that the error rate of the hormone receptor tests was several times higher than it had publicly disclosed.

More than 300 patients had been wrongfully excluded from being considered for antihormonal therapies like Tamoxifen, which has been clinically shown to improve a breast cancer patient's chances of survival.

Eastern Health has argued in court documents that Cameron should be able to see the external reviews, but that they should not be released publicly.