More strange examples of spending are emerging from eHealth Ontario even as Premier Dalton McGuinty said his government should have had more oversight in place.

"We should have had a greater understanding of what was happening on the ground and providing ongoing advice, even though this was an arm's length agency," he told reporters in Milton on Wednesday.

CTV Toronto reported the following:

  • One consultant billed $300 per hour over voicemail and video greetings and to draft a voicemail script
  • Another charged $200 per hour to discuss website issues such as italicizing "eHO" and the consistency of spelling eHealth
  • A third billed $300 per hour to review holiday banners and write a script for former CEO Sarah Cramer, who stepped down on the weekend, to read at the staff Christmas party

eHealth Ontario was created to place the medical records of Ontarians online, which would hopefully raise the efficiency of the health care system. It replaced the Smart Systems for Health Agency, which spent an estimated $650 million before being shut down.

Opposition politicians voiced outrage at these latest examples of apparently wasteful spending. The bill for untendered contracts has hit nearly $5 million.

"To pay somebody to produce a Christmas greeting, to pay somebody to write a short speech. These are the kinds of things where taxpayers ask themselves, "Where is our money going?" said Progressive Conservative MPP John Yakabuski.

CTV Toronto's Paul Bliss said the Tories are also concerned about invoices from Accenture, a huge consulting firm. The company has a $1.3-million contract with eHealth, but the invoices only contain the number of hours worked, not what was done.

However, Accenture's contract calls for a "reasonably detailed description" of the services performed for the period billed.

Bliss said that Accenture never called him back when he phoned to ask if they had ever submitted supplemental information to explain what they did for the hours billed.

"This is a joke, an ugly black joke," said NDP MPP Cheri DiNovo. "And it's a joke on the health consumers."

McGuinty said, "I think we're going to have to pick up our game, and put in a better set of rules."

David Caplan, the embattled health minister who has faced calls for his firing, told reporters, "I think our residents and Ontarians expect that we will get value for the hard-earned dollars that they send us."

Some observers have seen McGuinty's musing about oversight as hinting a cabinet shuffle, one made necessary by the departure of former Economic Development Minister Michael Bryant, which could see Caplan moved out of the health portfolio.

"Sounds like a clear indictment of his minister, I would suggest, by saying clearly he wasn't doing his job -- which is essentially what we've been saying for the past couple of weeks," said interim Progressive Conservative leader Bob Runciman.

NDP Leader Andrea Horvath agreed that Caplan should be replaced to restore public confidence.

"Whether it's an arm's-length agency or not, we still should expect some significant oversight for the health dollars that are being spent," she said.

"Ultimately, that responsibility, that obligation, lies with the minister of health."

The Coalition of Family Physicians said Wednesday that Caplan should be replaced. It also attacked Dr. Alan Hudson, chair of the eHealth board.

"We are at a crossroads in transformation where one path is carved out by seemingly entitled individuals who appear content to waste hundreds of millions of taxpayers' hard-earned money and who are not held accountable," states the letter signed by president Dr. Douglas Mark.

"Not even the Minister of Health, David Caplan, as he turns a blind eye to the shenanigans of his trusted leaders at eHealth who show up over and over again in various health care organizations with a trail littered with costly programs but questionable results."

Sarah Kramer, the former president and CEO of eHealth, is the first casualty. She was removed from her position on Sunday -- two days after the provincial legislature shut down for summer break.

Hudson gave her a $114,000 bonus on top of her $380,000 annual salary.

Caplan first said that bonus would be equivalent to what Kramer would have received at her old job at Cancer Care Ontario. But that agency said had Kramer stayed, she would have received only about $40,000.

The government has claimed tougher procurement rules have been in place at eHealth since late March and that no rules were broken in the awarding of the untendered contracts.

With a report from CTV Toronto's Paul Bliss and files from The Canadian Press