Ousted eHealth CEO Sarah Kramer Responds To Auditor General’s Report

The following is former eHealth CEO Sarah Kramer’s response to the Auditor General’s report.

On Wednesday, Jim McCarter alleged that a “lack of oversight” by the Ontario government allowed for rampant overspending within the organization.

In the past ten years, McCarter wrote, the province spent $1 billion to create electronic health records.

The goal is still years away. The board of directors at eHealth felt CEO Sarah Kramer had carte blanche to operate because she had been hired by chairman Alan Hudson “with the support of the premier,” McCarter wrote in the 50-page special report.


In his report today, the Auditor General acknowledges the tremendous challenges I faced when I took on the role of CEO of the newly-created eHealth Ontario agency in November of 2008.

The Auditor General catalogues, in great detail, the hundreds of millions of taxpayers’ dollars wasted on the government’s earlier, failed ehealth efforts, before the creation of eHealth Ontario. He acknowledges that the Premier of Ontario and the Chairman of eHealth Ontario both conveyed to me, at the time of my appointment, a strong sense of urgency to rapidly turn around the government’s failed ehealth efforts to date.

Finally, he lauds the Strategic Plan that eHealth Ontario developed and put in place in a matter of four months after I became CEO – when the government had been operating for some eight years on ehealth without any strategic plan at all.

Although the Auditor General acknowledges my good faith in the exercise of my authority as CEO, he refuses to accept that the urgency of the situation “justified and warranted” the direct action I took to turn around the disastrous ehealth situation in Ontario. Nor does he accept that the “relevant experience” of the experts we retained was a good enough reason to proceed under clear and unambiguous procurement rules allowing for such exemptions to open tender.

Ironically, while the Auditor General praises the eHealth Ontario Strategic Plan, he refuses to recognize the validity of the process that directly resulted in that plan. I must respectfully, but very strongly, disagree with him.

The 5.6 million dollars of eHealth Ontario contracts that are under dispute pale in comparison to the hundreds of millions of dollars squandered on ehealth prior to the creation of the agency. Indeed, the 5.6 million represents approximately the amount that the previous ehealth efforts would burn through in the course of a single week – with, as the Auditor General has pointed out, no concrete results. Moreover, that 5.6 million dollars was instrumental in delivering the Strategic Plan which the Auditor General lauds.
The contrast between that 5.6 million and the 800 million dollars that were spent before eHealth Ontario – with little or nothing to show for it – speaks for itself.

Finally, the Auditor General states that the Board of eHealth Ontario was unaware of the procurement practices that we were following. That is simply incorrect. Indeed, the Board was very explicitly and acutely aware that exemption rules in the procurement policies were being followed because of the urgency of the situation. Indeed, biographies of the individuals whose services were being contracted were presented to the Board.

These materials were all in the binders sent to Board members in preparation for Board meetings. Moreover, the members of the Board of Directors at that time were all senior government officials – current and former heads of crown agencies and assistant deputy ministers. That the Auditor General suggests that these individuals would somehow lack a proper understanding of procurement rules, or somehow be intimidated by the CEO or the Chair or by the priorities of the Premier, is a grave insult to them.

The Auditor General provided advance copies of his report to eHealth Ontario and the Ministry of Health for comment and corrections, prior to its finalizing the report. As I did not have the same opportunity, I shall be writing the Auditor General with more detailed response on the factual points I have raised in this statement.

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