A matter of perspective (II)

From His testimony yesterday before the Inquisition:

So there was a heavy onus on ministers because they had multiple duties, but, you know, there was what I would term an open relationship between us in the sense of, you know, if you need to come to us, come to us, and when we need to go to you, we'll go to you, from a big picture perspective.

I got to tell you from my own perspective, the detailed systems in the office is not something that I would get involved in, rightly or wrongly. That may be an abdication of responsibility, however, you know, from an office setup perspective, that's just not somewhere where I'd be involved deeply.

Now given the number of contacts, as I said, the hundred thousand plus contacts that come into the office, obviously people on the eighth floor are making decisions on a daily basis as to what moves forward and what doesn't move forward, and that's at every level, from our receptionist who gets inundated with calls, depending on what the issue of the day or the issue of the month is, that person alone receives a lot of frontline compliments and attack from both perspectives.

From a budgetary perspective, and a health care perspective particularly, you know, I remember sitting around the table and having to decide on teeth and glasses for people, some of the basic necessities of life so that people could see and eat, and having representation made to us by good people who are involved in the budget process that had to put everything before us and saying to us these are the kind of decisions that you have to make, Cabinet, and you have to prioritize them.

The Department works it out, and then it moves on and it's never seen or heard from again, from our perspective.

Based on that, that is a clear signal to our office that this matter is, for want of a better term, dormant right now in the sense from our perspective, we're not required to be involved and it is now in the hands of health officials, whether that happened to be the Department of Health or Eastern Health.

Well, you know, I guess, Mr. Coffey, if you look now as the result of the experience of what we've all gone through, you know, I can tell you right now that all senior officials are on red alert and that means from a perspective of, you know, major matters. Ministers have been now told categorically in a Cabinet meeting that if there's matters of important that, you know, need my attention and they need me involved and they affect the people in this province in a major way, whether that happens to be life safety or whatever else, then you need to come to me directly and you need to let me know directly.

From my own personal perspective, if there's something wrong, I'd like to know at the earliest available opportunity.

Certainly Mr. Forsey and his family, other MHAs, possible some Cabinet Ministers and I'm not doing that from memory, I'm just saying the type of nature, Lieutenant Governor and staff would have probably been — from a media perspective, it would have been Ms. Matthews and then possibly from a staff perspective, either Mr. Dinn or Mr. Noel who was with us at the time, if I remember correctly, yes.

The issue was minimized which is the term that was used, not in that context, but the term was used, so therefore, it may not be something that any members of my staff may have considered, you know, an issue to put before me at that particular point in time and, you know, again, that's from the perspective of the patients.

The big thing for us from a public perspective would be that the matter is under control, that the patients are fully informed, that they are being notified, that the damage has been controlled, and that they're basically trying to get to the bottom of it and come up with the answers for people.

Now at this particular point in time, I don't know if the ads were going out or when they went out, but there was a reassurance given to us then that this was very much under control, and people who needed to know, knew, and people who needed to be involved from an expert perspective were being very much involved.

I think from our own perspective, our own Ministers and officials were saying to Eastern Health, "let us know what you need from a resource perspective to resource up to get answers" and I think that was done, certainly told it was done and I assumed it was being done.

With regard to something like Herceptin, you know, when that drug or a suggestion is made from a pharmaceutical perspective as to what drugs are appropriate, that comes on recommendation, I think, if I remember correctly, from a panel of doctors or specialists who say to us, you know, this has been accepted by the appropriate agencies across the country or North America.

This kind of information though, you know, from the patient's perspective and people affected and, you know, this is important information on the way through that should be passed on to people who have an ability to probably do something about it.

Reading that, you would assume that the reviews are still ongoing, retesting is still going on at Mount Sinai, this is taking longer than it was expected to take, however, for me I wouldn't question that because if the process is taking longer, the last thing, I suppose, from a legal — from a medical perspective that people should do is fast track that process.

So it wouldn't have been my issue, put it that way, in that perspective.

Be from a co-ordination perspective, so that if this came out of left field in the House, so that I wouldn't just be hit between the two eyes and say, okay, there's an issue here that I'm not aware of, and I would be able to say in my own mind that I've looked to the Minister of Health and Tom would get up and handle that question.

And I just basically said yes and, so you know, from a disclosure perspective, Madam Commissioner, I don't know where procedurally we could ever go with this. In the criminal side there's disclosure requirements, but on the civil side, certainly from a public body perspective, you know, we wonder whether there should be more open disclosure because it's difficult to get it, but I do have to speak from a position where, like I can do it because, you know, I then have to answer to my Cabinet, but I know my Cabinet feels that, you know, information that's important in the public domain should be disclosed and that's an openness.

Now before you leave that though, if there was an area where I think we dropped the ball from a government perspective, it's there and the reason being is that the Department Health should have and/or knew the figures, the minister was briefed prior to that. I believe the minister was briefed in November.

So I suppose from a patient perspective, at least people who had their treatments changed, that was disclosed.

Yeah, and I mean, you know, from the minister's perspective, and I go back to the August briefing note, in fairness to Minister Osborne, he did not have that briefing note.

Well, it would be concern, I mean, just basically that he is concerned about what is going on over at Eastern Health from the perspective of, you know, information being provided, and again in his role as minister, he is responsible for that public confidence side.

No, just, you know, really a more just gearing up and trying to put information together as best we can and pulling together whatever records would be available from a briefing note perspective, what information I have, what information others have.

Talked about communications issues, and then there was a discussion on quality assurance, but what we did do was go through a chronology as to what happened from the start, what we had from a briefing note perspective, you know, what ministers knew and what ministers didn't know, and that was an issue, and everybody was brought up to speed.

First of all, from an adverse health perspective, on this event, also on a go - forward basis on major adverse health events, and also as probably the best person in government to be able to liaise with this Inquiry in order to produce and provide accurate information, and that's been a tough process, not because he hasn't been doing it right, it's because it's been difficult trying to get all the information due to database management issues and pitfalls and poor record keeping, and these are — you know, these are after the fact situations.

It's, you know, the problem, how it happened, when it happened and then when we move into damage control mode, and there are two completely different scenarios that are probably pretty clearly delineated from a time perspective, you know, and a lot of emphasis has been put on who did what after the fact.