ST. JOHN'S, N.L. - Premier Danny Williams is expected to explain before a public inquiry what, if anything, he knew of breast-cancer testing problems in Newfoundland before a local media report made the matter public in October 2005.
Questions have been raised about how the government responded to the affair after former health minister John Ottenheimer testified his staff told the premier's office of diagnostic testing problems on July 19, 2005.
But current Health Minister Ross Wiseman said Tuesday a second message that day, the contents of which haven't been made public, reveal that the premier's office was told "there was no action required" on the testing problems.
That piece of evidence wasn't provided to the inquiry until Monday night, after a senior civil servant unearthed it while conducting a search of e-mails dating back to that period.
Ottenheimer's testimony Monday jogged the memory of Robert Thompson, who served as the clerk of the provincial executive council at the time. After searching his archived e-mails he came across three messages dated July 19, 2005, that haven't been submitted to the inquiry.
Thompson sent those messages to Rolf Pritchard, lawyer for the Crown, who forwarded them to inquiry counsel Bern Coffey just before midnight Monday.
"The discovery of these e-mails, which had not previously come to light, was a significant surprise," Thompson wrote to Pritchard, explaining they came as a result of a change in software.
"It raises the question whether or not additional e-mails exist in these archives that should be searched again using (Microsoft) Outlook, which we can begin ASAP."
Thompson says the e-mails are correspondence between himself and three other bureaucrats, and dealt with an unspecified "health matter" at the Eastern Health authority.
The inquiry is examining how 383 breast-cancer patients were given inaccurate results on their tests and whether Eastern Health or any other responsible authorities responded to them and the public in an appropriate and timely manner.
Wiseman said he expects Williams, who has been away on personal time and not commented since Ottenheimer's testimony, to be called to testify at the inquiry.
"I suspect the premier will be there and through that process much information will come out," Wiseman said.
"And when he's called as a witness he, too, then will share in a public way what he personally knew and when, where and how he got that information."
The discovery of the July 19, 2005, e-mails forced further testimony from Ottenheimer to be postponed until Thursday.
Government staff will spend Wednesday trying to determine whether there are other e-mails that haven't been submitted to the inquiry.
Ottenheimer testified Monday that he became aware of problems with breast cancer testing on July 19, 2005, during a meeting with George Tilley, then the CEO of the Eastern Health authority.
He said his communications director told the premier's office about the problem when it became clear that the issue was "of critical public concern."
Last year, Williams told the legislature he first became aware of the faulty tests in October 2005 after a story appeared in the local independent weekly newspaper outlining problems with Eastern Health's breast-cancer testing.
The full scope of the testing errors wasn't revealed until May 2007, after court documents were filed in the province's Supreme Court as part of a class-action lawsuit against Eastern Health showing more than 300 patients were affected by the botched tests.
The inquiry is focusing on hormone-receptor tests, which are a valuable tool that doctors use in determining the course of treatment for breast cancer patients.
If patients are found to be estrogen-and/or progesterone-positive, they may respond to hormone therapy such as Tamoxifen. If not, they may be given a range of other treatments, or no treatment at all, depending on the characteristics of the patient's cancer.
Problems with this kind of breast-cancer testing weren't detected until the spring of 2005, when doctors began questioning the hormone-receptor test results of a patient with invasive lobular carcinoma, a form of breast cancer.
After retesting, it was discovered that the initial test result was wrong, as were those for a small sample of other patients.
Eastern Health subsequently halted testing in its lab and transferred its hormone-receptor tests to Mount Sinai Hospital in Toronto.
The health board then started a review of all hormone-receptor tests from 1997 to 2005.
