One-third of the province's public health units inspected less than half of the establishments in their area where the risk of getting sick from food is higher - banquet halls, nursing homes, hospitals and big restaurants with varied menus.

And a significant number of health units which did inspections found that fewer than half the food handlers at high-risk locations had the required training to help them recognize and prevent food-borne illnesses.

"We don't have any evidence that our health is at risk," assistant provincial auditor Jim McCarter said at a news conference.

"What we're saying is that because the government isn't monitoring this, there's certainly an increased risk to the public."

"It's certainly a riskier situation than if these inspections were being done annually as required."

The report also cites weakness in the province's public health units to share information quickly and effectively about disease outbreaks and other health issues.

While the SARS outbreak in Ontario occurred near the end of the audit and isn't included, the report notes that the need for the Ministry of Health to know that public health units are working effectively "is heightened in light of the emergence of new diseases such as West Nile virus and SARS."

Local public health units can't always share information with other units or the ministry, the report states, often because different computer systems are used by each unit.

"This may limit a health unit's ability to manage fast-spreading outbreaks that may have occurred in other jurisdictions in Ontario," the report said.

"When you get things like communicable diseases, it's very important to be able to share that information," McCarter said.

"We are recommending that they have to do a better job."

During the SARS outbreak, although health units knew they didn't have the necessary information systems in place, they "made a real effort" to ensure the information was getting out to those who needed it, McCarter said.

Health Minister George Smitherman said the auditor's report indicates there's a lot of work to do to improve the province's public health system.

The report "highlights that in Ontario, not only do we have a fiscal deficit, but we have a public health deficit - a deficit in terms of our capacity to properly protect Ontarians," Smitherman said.

"I think we've done a lot of work in terms of preparing better for any outbreaks, but the report also helps to highlight that as a government we have work to do and we're going to get on with it."

The audit of the Health Ministry's public health division found that while the 2002 per capita funding for mandatory health programs and services averaged $37, it ranged from about $23 to $64 per person depending on geographical location. Levels fall off in the northern areas of Ontario.

Even with West Nile virus being a top concern, the Health Ministry had not yet developed a process to make sure local health units were assessing the risk and taking action to decrease the incidence of the disease, the auditor said.

The auditor also noted that health units are having a hard time finding properly trained candidates to be medical officers of health - a requirement for heath units.

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