TORONTO - A culture of secrecy spread to all 14 Local Health Integration Networks set up by the Liberal government, "creeping like hogweed through Ontario communities," ombudsman Andre Marin reported Tuesday.

The ombudsman found the Hamilton-Niagara-Haldimand-Brant network held "illegal, secret meetings" to discuss restructuring hospital services in Hamilton and the closure of emergency rooms in Fort Erie and Port Colborne.

The Hamilton-area network met its lawful requirement to consult the community on the proposed hospital changes by talking with people on the golf course or in line at the grocery store, reported Marin.

"Our investigation revealed that ... the reality of 'community engagement' is that it's a wishy-washy grey zone -- and this particular LHIN took advantage of that to render it almost meaningless," Marin said at a news conference.

"They used these secret meetings to discuss the restructuring plans with the key players away from public view."

Health Minister Deb Matthews insisted Tuesday that all the networks "were in compliance with their bylaws," but the ombudsman said the agencies passed "illegal" bylaws so they could meet in secret.

The Ministry of Health had "a last minute change of heart" Monday and agreed to tell the networks to stop the secret meetings, said Marin.

The agencies opened themselves up to legal challenges of their decisions by "being sneaky" and not properly documenting the discussions held behind closed doors, added the ombudsman.

"Members of the public are left to wonder if the meetings they are allowed to attend are just a rubber stamp, with the real engagement going on in private, inside the LHIN's boardroom," he said.

The report, called The LHIN Spin, didn't look into the merits of the decision to close the ERs -- Marin doesn't have jurisdiction over hospitals -- but said the Hamilton-area network clearly failed to properly consult the community on its restructuring plans.

Even though they were set up so health-care decisions are made at a local level, Marin said the networks' "reality of community decision-making has fallen far short of the political spin."

The Ontario Health Coalition, a citizen's advocacy group, said the Liberal government seriously underestimates the public's anger at the networks.

"In my 10 years as a health-care advocate I have never experienced the kind of deep hatred towards any public institution that local communities hold towards the LHINs, and it's because of the arrogant, high-handed decision making," said OHC spokeswoman Natalie Mehra.

"People are livid, and if the McGuinty government doesn't realize it, it will be an issue in the election next year."

The Opposition vowed to scrap all 14 networks and invest the money that is spent on that level of bureaucracy back into front line health services if it wins next year's election.

"The fact that the ombudsman has clearly said that these decisions were arrived at by an illegal bylaw and secret meetings tells me that those decisions to close down those (Niagara-area) ERs must be revisited immediately," said Progressive Conservative Leader Tim Hudak.

"I reject the premise that the LHINs are about regionalization. I think they're a veil for the government to hide behind."

The New Democrats also accused the Liberal government of hiding behind the networks whenever unpopular health-care decisions have to be announced, and called the ombudsman's report "deeply, deeply" troubling.

"Instead of a smart system of accountable, community health care, we have a bloated, unaccountable bureaucracy," said NDP Leader Andrea Horwath.

"I'm calling for a moratorium on all hospital restructuring until a full scale review of LHINs has taken place."

Premier Dalton McGuinty said Tuesday that his government would rather make improvements to the health networks as needed, rather than engage in the full review that was promised when they were set up in 2006.

However, a spokesman for the premier later clarified a review of the networks was still required by law, but couldn't say when it will be held. Opposition critics predicted it won't come until after next year's Ontario election.