A damning parliamentary report has not ruled out the possibility that St Vincent's Hospital attempted to cover up the chemotherapy dosing scandal that has embroiled the Sydney institution for almost two years.
The rigorous legislative committee inquiry into off-protocol chemotherapy prescribing in NSW has delivered its final report, after investigating the circumstances surrounding oncologist Dr John Grygiel, who flat-dosed or underdosed at least 129 cancer patients.
The extent of the practice was not made public until February 2016, despite it coming to the hospital's attention in June 2015. Many of his patients found out through media reports.
"The committee is not able to discount the possibility of a cover-up on the part of St Vincent's Hospital," the report concluded.
"St Vincent's hospital Sydney failed to prevent and to respond effectively to the off-protocol prescribing of chemotherapy that occurred in the hospital.
"Senior management put their public standing ahead of the best interests of their patients," it read, citing "individual and collective human error" coupled with "systemic failures".
The hospital did not escalate numerous concerns raised by staff for more than a decade and did not understand the seriousness of the issue, the document says.
"A key theme of our inquiry has been trust - the profound trust that cancer patients and their families place in their treating doctors and also in their hospital," said committee chair Paul Green MLC.
"Every patient must be able to trust that their doctor is acting within the bounds of reasonable care, with their consent. They must also be able to trust that if their doctor's actions are called into question, their hospital will act quickly to inform and protect them," he said.
Labor and Greens legislative committee members had recommended that St Vincent's be subject to the same oversight as all of the state's public hospitals. But the recommendation was shot down by government and other members of the committee.
"We are disappointed that the recommendations that St vincent's be incorporated into the NSW Health system and subject to the governance and oversight of a public hospital [did not get up]," Greens committee member Jeremy Buckingham said.
"St Vincent's did and continues to put their cooperate and professional reputation before the interests of its patients and they should be ashamed of that.
"In all my time in parliament, this has been one of the most harrowing and difficult experiences listening to testimony of patients and families affected. Some of whom I believe paid for this scandal with their lives and that's a very sad state of affairs," he said.
Labor health spokesman Walt Secord said the State Government had failed to properly protect patients and allowed St Vincent's hospital to put its public standing ahead of the best interests of patients.
"This sorry saga lies squarely at the feet of the State Government, which did not properly hold St Vincent's hospital to account – resulting in the hospital covering up the chemotherapy dosage scandal," Mr Secord said.
St Vincent's Hospital rejected "in the strongest possible terms" claims it tried to cover up the scandal.
"The independent and exhaustive inquiry into this matter, led by the Cancer Institute NSW's Professor David Currow, did not produce any material to suggest anything of that nature had occurred," a hospital spokesman said in a statement.
"It found that Dr Grygiel's practice of under dosing 'remained unknown to senior hospital management until August 2015'."
The hospital acknowledged it failed to appreciate the seriousness of what occurred and should have handled the issue better.
Last year, St Vincent's Hospital group chief executive Toby Hall apologised to the committee and acknowledged senior staff failed to properly handle the issue.
"Once again, St Vincent's apologises to all patients and families who have experienced anxiety or concern over their treatment," the spokesman said.
The committee recommended the Cancer Institute publish all patient evaluations and outcomes of patients who received off-protocol chemotherapy flat-dosing, and that NSW Health publish the findings of its audit of cancer patients across NSW.