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Dalton McGuinty says LHINs can do a better job of communicating.

Ontario's Local Health Integration Networks are an important way to get local input on critical health care decisions, but they need to do a better job of consulting their communities, Premier Dalton McGuinty said Thursday.

The 14 agencies were set up by the Liberal government in 2007 to dole out $21.5 billion a year in health funding to hospitals, clinics, community care and long-term care homes.

 They are  still developing and need more direction from the province, said McGuinty.

"When it comes to LHINs, they're still relatively new creatures," he said after touring a hospital in Sudbury.

"They're still kind of learning how to run, and we've got to make sure that we provide appropriate guidelines as they carry out their responsibilities."

It was the first time McGuinty commented on the LHINs since ombudsman Andre Marin issued a scathing report Tuesday accusing local health agencies of holding "illegal" secret meetings to discuss plans to restructure hospital services and close emergency rooms.

"We will continue to find ways to improve the way that they function and interact with the community," said McGuinty.

The original idea of getting more local involvement about delivery of health care services instead of having bureaucrats in Toronto make decisions for all regions is a valid one worth defending, he added.

"One of the good points the ombudsman made was that you've got to be more open, more transparent, and be very careful about holding these in-camera meetings," he said.

"If you're going to represent the community then the community should have access to you, they should understand your deliberations and those kinds of things. To me that makes good sense."

The opposition parties and health care advocates were fuming because McGuinty has postponed an already overdue review of the health networks until after next year's provincial election.

The New Democrats want a moratorium on all hospital restructuring plans until that promised review is completed, while the Tories said they would shut down the LHINs if they win the election.

"Dalton McGuinty must stop helping the LHINs cover their tracks," Progressive Conservative health critic Christine Elliott said Thursday.

"We are calling on the McGuinty government to immediately reinstate the cancelled legislative review, reveal how many illegal and secret meetings have been held at each LHIN, and inform the public what the LHINs were discussing behind closed doors."

NDP Leader Andrea Horwath spent Thursday in Fort Erie, one of two Niagara-area communities that saw their emergency rooms shut down by the local LHIN in a process the ombudsman said was not only secretive, but likely open to a judicial review.

The ombudsman's report proves the LHIN decision to close emergency rooms in Fort Erie and Port Colborne wasn't legitimate and should be reviewed by the government, said Horwath.

"That's the very, very least that this government should be doing," she said.

"If the LHINs were flawed in terms of their decision-making process, which is clearly what the ombudsman indicated, then it stands to reason that there's a significant possibility the decisions themselves were flawed."

The Ontario Health Coalition, a citizen's advocacy group, said the Liberal government has seriously underestimated the level of public anger over the LHINs and will face the consequences in next year's election if things don't change.

"It will be an election issue," said coalition spokeswoman Natalie Mehra.

"I think that it is the hot button issue in many, many communities, including Liberal ridings where local hospitals are facing major service cuts."