Former eHealth Ontario chief executive officer Sarah Kramer landed the top job at the troubled agency after Premier Dalton McGuinty directly intervened in her appointment, over the objections of some of his own civil servants.
Ms. Kramer abruptly resigned from eHealth Ontario in June, amid scandal over lucrative contracts awarded without competitive tenders and nickel-and-dime spending by consultants. It became one of the most politically damaging episodes of the McGuinty government's 5 1/2 years in power.
Only the resignations of Ms. Kramer and, later, eHealth chairman Alan Hudson, dampened the outrage over the agency's free-spending ways. When Mr. McGuinty announced the departure of Dr. Hudson, he said, “The buck stops with me,” and introduced new rules that ban any government ministry or agency from awarding contracts to consultants without competitive tenders. Even so, the Premier has been largely insulated from the scandal.
Documents obtained by The Globe and Mail illuminate the hands-on role played in appointing and supporting eHealth's leaders by Mr. McGuinty. Senior officials in the Ministry of Health had opposed the selection of Ms. Kramer because they felt she did not have enough experience to oversee the daunting task of modernizing the province's medical records, one of the government's top priorities, according to sources close to the situation.
Any obstacle to Ms. Kramer assuming her new duties disappeared the day she met face to face with Mr. McGuinty in his Queen's Park office, documents show.
Those documents and interviews with eHealth insiders point to a wider theme of a fledgling government agency that cut corners and bypassed the normal bureaucratic checks and balances in its rush to play catch-up with many other provinces and create a digital record of every resident's medical history by 2015.
Ms. Kramer did not have to go through the normal channels government agencies use to find a chief executive officer. And Mr. McGuinty was directly involved in her hiring, according to sources close to the situation. The board of directors of a government agency typically appoints the top executive, following a competitive search that identifies a short list of candidates. But Ms. Kramer did not have to compete against others, and she was appointed directly by the premier through an order in council.
Her appointment was requested by Dr. Hudson, a neurosurgeon and former hospital president renowned for fixing problems in health care, and Mr. McGuinty's hand-picked choice for chairman of eHealth Ontario.
Dr. Hudson told the Premier he would take the job on one condition: if he could hire his protégé as chief executive officer, according to the sources. Dr. Hudson had worked with Ms. Kramer at Cancer Care Ontario, where he was president and she was the chief information officer. He was under enormous pressure to fix the province's medical records and he wanted someone he could trust to get the job done, the sources said.
“Hudson made it very clear to all kinds of people that it was a two-for-one deal,” said a source close to the situation.
Dr. Hudson had taken the reins of an agency whose predecessor had spent $700-million with little to show for it. A review by Deloitte Consulting in 2006 found the Smart Systems for Health Agency “is struggling and lacks strategic direction.”
Some senior bureaucrats, including deputy health minister Ron Sapsford and then-assistant deputy health minister Gail Peach, opposed Dr. Hudson's choice for CEO, the sources said. Although Ms. Kramer had done an excellent job at Cancer Care, they did not think she had enough experience to run an organization that had a multi-million-dollar mandate to replace the province's paper-based medical records with digital ones.
“It raised a lot of eyebrows everywhere,” said a former senior civil servant who asked not to be named. “Everybody thought, ‘That's a big leap.' ”
Ms. Kramer could not be located for comment.
