Former head of Eastern Health George Tilley took responsibility at the Cameron inquiry for how cancer patients learned of testing mistakes. (CBC)

The former head of the health authority at the centre of Newfoundland and Labrador's breast cancer testing scandal has accepted responsibility for how patients learned about flawed tests that may have affected their care.

George Tilley, who concluded his testimony Tuesday at the Cameron inquiry in St. John's, said Eastern Health could have done a better job communicating problems about lab testing with patients, some of whom did not learn about their own involvement for more than two years after retesting started.

In June 2007, the government realized that even though Eastern Health said it had contacted all affected patients, it was clearly not the case.

The inquiry has been told in recent weeks that patients were first contacted by telephone, often through their physicians, and that a subsequent patient letter went out with errors. Many patients first learned of problems through media reports, and some patients received no communications at all.

Tilley, who resigned as chief executive officer of Eastern Health in July 2007, told Justice Margaret Cameron that he wished things had been done differently with what he suggested was an overwhelming problem.

"The challenge that we all now have to struggle with is how do we deal with situations that are literally in the hundreds, rather than in the single digits," Tilley said.

"Because I think, in the ideal world, we would have wanted a person to be able to look the patient into the eye directly, be able to give them all the time they needed to be able to understand the complexity of the issue, share their concerns, share the emotions, provide whatever assistance that could be had," said Tilley.

"So it's unfortunate that it turned out that way, and I accept the criticism, but it certainly wasn't designed to be that way. And because I was head of the organization at that time, I take responsibility for that," said Tilley.

"It is something I think that I think everyone in the organization [wishes] it had not turned out that way."

By coincidence, Tilley's comments came as Eastern Health sent, by registered letter, written apologies to breast cancer patients affected by the testing errors.

Cancer Society cites lack of overview report

Meanwhile, Jennifer Newbury, counsel for the Canadian Cancer Society, pressed Tilley on why the authority did not write a single, overall report on what it did to address problems with hormone receptor tests, which help determine the course of a treatment that a breast cancer patient will receive.

"Would you agree that had a written report been produced, that the very exercise of writing such an official report might have provided some clarity of thought on the issue?" Newbury asked Tilley.

"It's possible," Tilley replied.

Tilley reiterated his view that Eastern Health at the time was creating what he calls a "blameless culture," in which staff could report problems without fear of reprisal, and so that staff could instead learn from their mistakes.

Tilley admitted that the approach is a tough sell publicly.

"If there is an incident that occurs, I think we'd generally be leaning towards 'How do you rehabilitate or how do you ensure that that person learns from this experience?'" Tilley testified.

"I do take exception to the comments that get made in the media that heads should roll. I've heard them many times — in fact, too many times," he said.

"It's just a lack of understanding of what we're trying to achieve here."