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Opposition members have called for the resignation of Ontario Health Minister David Caplan.

The eHealth Ontario saga widened Monday with revelations that a consultant was paid $30,000 for 78 hours work, and the son of board chairman Alan Hudson worked for a firm closely connected to the agency before leaving for IBM.

With Ontario Health Minister David Caplan conceding that reforms are necessary at the embattled agency, documents show that Penny Ballem was paid for the 78 hours over the objections of an eHealth employee who said no contract was signed for her work.

Dr. Ballem got the consulting assignment through Michael Guerriere, a managing partner at Courtyard Group, which itself has lucrative contracts with eHealth. The eHealth employee was told to process the payment to Dr. Ballem because Dr. Guerriere could validate her invoice, the documents show.

Dr. Ballem, a former deputy health minister in British Columbia, said in an interview Monday that she was to lead Ontario's plan to improve the management of diabetes. But she had to bow out last December after she was appointed city manager of Vancouver.

She said she is well known in the health-care sector for developing British Columbia's electronic records as a deputy minister.

"The senior health community is pretty small in this country," she said.

Dr. Guerriere worked with Dr. Hudson at the University Health Network until 2000 and have maintained close ties since.

Dr. Hudson's son at one time ran the New York office of Courtyard Group. An official at Courtyard confirmed Monday that Roy Hudson worked at the firm from December, 2002, until March, 2006 when he left to join IBM.

Dr. Ballem said she had no idea a staff member at eHealth had questioned her invoice for the 78 hours she worked over the three-month period ending last December. She was paid $3,000 a day, making her one of the more generously compensated consultants.

According to copies of internal e-mails written by eHealth officials and obtained by The Globe, an official at the agency said, "In my view, a signed agreement is not necessary (and all but impossible here) if we're satisfied that she performed the service that she was retained to do. Michael Guerriere is in the process of confirming this and validating her invoice."

Dr. Guerriere could not be reached for comment. Dave Wattling, a managing partner at Courtyard, said in an e-mail response that the ultimate approval for Dr. Ballem's invoices would have rested with others at eHealth.

"At no point did Dr. Guerriere have signing authority for any matters - including contracts or invoices - at eHealth Ontario," Mr. Wattling said.

Sarah Kramer resigned as chief executive officer this weekend after only seven months on the job and amid a scandal involving sole-sourced contracts and rich consultancy fees to Courtyard and other firms. She received $316,670 in severance pay, the equivalent of 10 months of her annual salary of $380,000.

eHealth cancelled three of the consulting contracts a week before Ms. Kramer's departure, including one awarded to Dr. Guerriere, agency spokeswoman Deanna Allen said. Dr. Guerriere had billed the agency $3,000 a day while temporarily serving as its senior vice-president of strategy, the documents show.

Courtyard itself was awarded three contracts worth just under $2-million beginning in October, 2008, according to copies of contracts obtained by The Globe. Ms. Allen said one of the firm's contracts remains in place, to help eHealth develop the province's diabetes strategy.

Michael Decter, a former deputy minister of health for Ontario who was recently appointed to the eHealth board, said Monday that he couldn't comment because Dr. Hudson speaks for the board. Dr. Hudson could not be reached.

With a report from Lisa Priest

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