Health Minister Ross Wiseman insisted he did not see a controversial Eastern Health release until the public did, although documents show his officials were given an advance copy to review. (CBC)

Newfoundland and Labrador government officials had been directly involved in a news release two months ago that prompted Premier Danny Williams and others to lash out at Eastern Health, documents obtained by CBC News show.

"They should be shot over there," Williams said about Eastern Health's decision on April 3 to release information that the authority had missed several dozen breast cancer patients in a massive retesting exercise.

The revelation was made late on a Friday afternoon, and the details were buried in a news release that went out under an innocuous looking headline.

Williams and Health Minister Ross Wiseman both complained that Eastern Health was behaving poorly in the wake of the Cameron inquiry, which spent months looking at Eastern Health's communications practices.

But documents obtained by CBC News through access-to-information legislation show that senior government officials had seen the release in advance, and that government played a role in Eastern Health publicly releasing information without the certainty that it knew all the facts.

The documents also show an intense struggle between the government and Eastern Health, which operates at arm's length from the province.

The issue first came to officials' attention on March 25, when new information confirmed that as few as 16 patients had been missed.

Notes taken by Jennifer Guy, Eastern Health's vice-president of communications, show Robert Thompson, a senior civil servant who advises cabinet on health matters, "notified the minister" by March 30, possibly earlier. (Wiseman told the legislature he did not learn of the issue until April 2.)

On March 31, Deputy Minister Don Keats wrote an email to Louise Jones, the acting chief executive officer of Eastern Health, to say the "minister needs a briefing on latest work" on the issue. "Also need to discuss disclosure," Keats wrote.

That day, Jones begged for more time. "It will be the end of the week before we have a handle on the 64 new files that we received today."

Quality assurance managers 'outraged'

On Thursday, April 2, Wiseman took the matter to cabinet, which ordered Eastern Health to go public about the matter.

Guy's handwritten notes, which were among many documents CBC News obtained, show Jones was very upset about the directive, and that quality assurance managers were "outraged" that "patient disclosure [would be] compromised."

By Friday, April 3, Eastern Health officials still felt they did not know enough. Even though Eastern Health has a policy against disclosing information on Fridays, officials rushed to prepare a release.

Louise Jones, Eastern Health's interim CEO, pleaded with government officials for more time for the authority to learn how dozens of breast cancer patients had been missed. (CBC)But draft copies of a news release show that, from the beginning, the new numbers would not be the focus of what Eastern Health wanted to say. As with the final release, the drafts put that information — which would shock patients — in the middle of the text.

After the uproar, Wiseman told the house of assembly that he played no role in creating the news release, and that he got it at the same time as the public.

"This was not a joint effort," Wiseman said at the time.

But one email shows that the final draft had been sent hours in advance to Wiseman's office, and had been given to the department's communications director.

Guy's notes show that the "approval process" for the release "included government," which she wrote "came back with commentary" that was included in the final release.

Soon after the release, Eastern Health amended the numbers relating to patients that it had missed in the retesting process, further contributing to public outrage and mistrust.

But the documents also show that Eastern Health staff had been in emotional uproar in the days before and after the forced release, in part because of government's role.

"We were extremely uncomfortable being asked to go public while we were in the process of patient identification and patient disclosure," says a note handwritten by communications official Deborah Collins.

"It goes against every principle in health care, especially on a Friday when we were not in a position to offer the only assurance that would have made any difference to patients."

After issuing the original release, Eastern Health refused to make any officials available for an immediate interview.

The authority later said it would never repeat that practice.