Pat Pilgrim struggled to maintain her composure while reading a statement Thursday at the Cameron inquiry. (CBC)

Between tears and emotional pauses, a senior health manager apologized Thursday for what Newfoundland and Labrador breast cancer patients have endured.

But Pat Pilgrim, a chief operating officer at Eastern Health, also told the Cameron inquiry in St. John's that politicians hold some blame for how they responded to a crisis involving faulty cancer tests.

She also pleaded with the public for co-operation as the authority struggles to restore confidence in its work.

After vigorous questioning through the week, Pilgrim concluded her testimony with an apology to patients. She said Eastern Health made the right call in 2005 by immediately ordering retests of hormone receptor tests, but then erred in deciding not to tell patients what was happening.

"We set out to help, not to create further trauma for those who had experienced this diagnosis and treatment," an obviously upset Pilgrim told Justice Margaret Cameron.

"I also regret, as a longtime person within the health-care system and someone who really believes that we have a good health-care system in this province, I regret that the impact this has had and how it has shaken patients' faith and also the public's faith in our health-care system," Pilgrim said.

Pilgrim, who previously testified that Eastern Health struggled to even understand the breast cancer testing mistakes in 2005 while it was still forming after seven smaller boards were amalgamated, said physicians, managers and other staff at Eastern Health have been affected by what politicians have done.

Politicians have 'gravely affected' system

"We, within Eastern Health, have never before experienced the magnitude of an issue such as this," she said.

'We do not always do everything right, but we do try to do the best that we can and always with the patients' interest at hand.'—Pat Pilgrim

"The reaction from our politicians was unprecedented and has impacted our relationship with them. I know that politicians come and go, but this has gravely affected our system throughout this process," she said.

In particular, Pilgrim noted key health managers who were sacked in 2007, amid an enormous public reaction to disclosures that Eastern Health had not reported that the extent of breast cancer testing errors was much broader than officials had suggested.

"We have lost some very important leaders within health care in this province. I refer specifically to Mr. George Tilley and Mr. John Abbott," said Pilgrim.

Tilley, the former chief executive officer of Eastern Health, resigned in July 2007 amid disclosures over a separate issue involving flawed radiology tests at a southern Newfoundland hospital.

Abbott, the former deputy minister of health, resigned after the government asked him to transfer to the tourism department. Abbott came into conflict with the Williams government when it learned that he had not shared critical information with former health minister Tom Osborne.

'Rules of engagement' needed

"I feel very strongly that we cannot afford this type of loss which is certainly being felt in the health-care system to this day," said Pilgrim.

"Rules of engagement need to be clarified between the regional health authorities and the governing party of the day. We never, ever want to be in this position again," she said.

Pilgrim, meanwhile, asked the public to support Eastern Health staff as the authority tries to transform itself. Pilgrim, who said she will be retired by the time the authority "actually gets to where it wants to go," told Cameron that the authority's credibility is on the line.

"Patients and the public have been bombarded with media coverage that has presented a picture of Eastern Health as this nameless, overwhelming, large entity that did not openly share and probably even … manipulated information they shared to somehow protect the organization and its insurers," Pilgrim said.

"We do not always do everything right, but we do try to do the best that we can and always with the patients' interest at hand," she said.

"[We] have never experienced this type of an issue and this magnitude, and I would say very honestly to you that we did not know how to manage this and we did manage it poorly, parts of it. I would also suggest to you that you would not find many health care organizations who could have done better, given the context of what we were working in."

Cameron has been hearing evidence since March on how hundreds of hormone receptor tests — which are used to help determine whether a breast cancer patient can benefit from the potent antihormonal drug Tamoxifen — had inaccurate results, and on what officials did to respond to the errors.