Eastern Health 'a real blur' during early months, cancer inquiry told

The former top doctor at Eastern Health has told a judicial inquiry that revelations of breast cancer testing problems emerged during the authority's chaotic early months.

Dr. Bob Williams was appointed vice-president of Eastern Health when it came into being in January 2005, months after the Newfoundland and Labrador government forced an amalgamation of regional hospital, nursing home and community health boards into just four large boards.

Williams, who retired in September 2006, said Eastern Health was given little time to prepare for its new mission, with a single board now responsible for an unprecedented range of service.

"Starting in January 2005 until I left the organization in September 2006, that 21-month period is a real blur," Williams told Justice Margaret Cameron.

Williams was accustomed to senior positions in the health-care system, having served as a deputy minister of health for nine years.

However, he told the inquiry Wednesday that things were never more taxing in his career than during Eastern Health's first months.

The provincial government, he said, had the expectation that Eastern Health would be able to hit the ground running.

"There [are] two approaches you can take to reorganization," Williams said.

"You can take the approach if you're going to do it anyway, let's knock things together fairly quickly, or the other approach is that I think is more valid to use in health care is that health care is a complex and sensitive area and when you make change, you can often cause problems," he said.

"So I think a slower approach probably is more relevant … So this, everything, and then we had [that] major issue with the current issue we're dealing with here," said Williams, referring to how Eastern Health realized in the spring of 2005 that there were problems with hormone receptor testing.

In May 2005, Williams told the inquiry, he received a call from clinical pathology chief Dr. Donald Cook, who told him, "We've got a problem."

At that point, the authority knew that at least one result of the estrogen receptor and progesterone receptor testing — which determines the course of treatment for a breast cancer patient — was inaccurate.

At that point, Williams said, no one knew how big the problem was.

"So we talked about it and thought maybe it's just a bad batch, that they were going to do some more testing at the time," Williams said.

Williams is expected to tell the inquiry more about Eastern Health's response to those problems in the coming days.

Cameron is examining what went wrong with hormone receptor testing between 1997 and 2005, and with how officials responded to the problems thereafter.