Health Minister Ross Wiseman: 'I don't think that the [significance of] events of last 12 or 18 months has been lost on anyone in this province.' (CBC)

Still stinging from revelations that have come out during a judicial inquiry into breast cancer testing mistakes, the Newfoundland and Labrador government says it is introducing more sweeping rules to protect patient safety.

Health Minister Ross Wiseman on Wednesday released the findings of the Task Force on Adverse Health Events, which the government created in May 2007 while it was reeling from revelations that errors in hormone receptor tests were far more widespread than had been believed.

The government at the same time also ordered a judicial inquiry. Justice Margaret Cameron finished hearing testimony in late October and is expected to complete her report by March.

Wiseman said the task force's work will lead to a system where staff — nurses, social workers, lab workers among them — will be expected to report mistakes.

"I don't think that the [significance of] events of the last 12 or 18 months has been lost on anyone in this province," said Wiseman.

"There's been a couple of real significant lessons coming out of it."

While staff reports what are called "undesirable occurrences" by the thousands each year — about 15,000 in the last year — officials feel many are being missed.

The task force recommends amending the Regional Health Authorities Act to make it mandatory for staff to report adverse events. It also recommends a legislative change that will protect employees from reprisals.

As well, if an error results in harm to a patient, the health board will have to inform the patient.

Wiseman said that should lead to greater transparency, which was often highlighted as a problem at the Cameron inquiry. The inquiry examined how a pathology lab came to produce wrong results for hundreds of breast cancer patients over an eight-year period.

The inquiry was told that not only were patients not told promptly about the errors but that officials at Eastern Health, by far the largest health authority in the province, deliberately withheld information from the public.

The task force, though, recommended keeping some secrets. It said peer reviews conducted within hospitals should not be public.

However, as for health boards withholding information at news conferences — which was highlighted as a critical fault for Eastern Health — Wiseman promised that will not happen again.

"These sorts of issues should not occur in the future," he said.

The government expects to see a steep rise in the number of occurrence reports, with the number jumping by a third, as compliance takes effect.

Wiseman said that will lead to improvements in the health care system.

The improvements, though, will take money and time. At least $3 million has been earmarked per year, and Wiseman said it will take another six years before all of the electronic databases in the province's health-care system are fully up to scratch.

The Cameron inquiry had been told that one of the greatest issues plaguing Eastern Health in the early stages of the breast cancer testing issue involved differing systems used in various hospitals around the province.