TORONTO - Premier Dalton McGuinty's right-hand man must share the blame and step down in the wake of a scathing report on troubled eHealth Ontario that prompted another senior minister to quit, critics demanded Wednesday.

Deputy premier George Smitherman presided over health for four years before David Caplan took over as health minister in 2008, and should also take responsibility for the millions of dollars wasted in the push to create electronic health records under his watch, opposition parties said.

"It seems very clear when you look through the auditor's report that David Caplan simply got caught carrying a lot of George Smitherman's dirty laundry," said Conservative Leader Tim Hudak.

"Quite frankly, I expected to have two ministers resign."

Auditor general Jim McCarter's long-awaited report found a lack of government oversight allowed consultants to run amok as the province spent $1 billion at eHealth with little to show for it.

At the same time McCarter was delivering his damning report, Deb Matthews was being sworn in behind closed doors as Caplan's replacement.

Laurel Broten, a former environment minister who had languished for years in the Liberal backbenches, took over Matthews's job as minister of children and youth services.

Both women were absent from the legislature Wednesday and requests to speak to Matthews were denied by the premier's staff.

McGuinty defended his choice in allowing Caplan to take the fall, suggesting it was his job as the current health minister to offer his resignation, not Smitherman's.

"I work with circumstances as I find them, and in keeping with parliamentary tradition, it's important that when information comes to the fore, that the minister who's in place at that time, who's up to bat, accepts responsibility," said McGuinty.

"That's our tradition of ministerial responsibility."

Caplan, he added, "did the responsible thing and the honourable thing by accepting responsibility."

NDP Leader Andrea Horwath, who along with the Conservatives had called for Caplan's head for months, demanded to know why it took so long for the minister to leave -- and why Smitherman's head wasn't on the chopping block.

"If I was the premier of this province I wouldn't have Minister Smitherman in cabinet, nor would I have the current deputy minister who oversaw all these things in place either," she said.

Smitherman, who is also mulling a bid for Toronto mayor, bristled at accusations that Caplan fell on his sword to preserve his colleague's political ambitions.

"I don't have survivor guilt but I feel terribly, of course, about the loss of a friend and a colleague," said Smitherman, who also serves as minister of energy and infrastructure.

"I know how hard David Caplan works. I know he's a public servant and I have every expectation that he'll have an opportunity to serve again."

Smitherman said he gave "no consideration" to resigning his cabinet post over the eHealth scandal and did his best when he held the massive health portfolio, which accounts for nearly half of every dollar the government spends.

"A minister has a small staff and it's obviously a very big ministry," he added.

McCarter's report linked the awarding of untendered contracts to McGuinty's role in the hiring of eHealth CEO Sarah Kramer, who abruptly left the agency over the summer along with chairman Dr. Alan Hudson.

The board of directors at eHealth, the agency tasked with creating electronic health records, felt it had little power over Kramer because she had been hired by chairman Alan Hudson "with the support of the premier," McCarter said.

That failure in oversight is the reason why he had to leave cabinet, Caplan said.

"This was not an easy decision to make, but it's the responsible thing to do," he said in a statement Wednesday.

As infrastructure minister, Caplan had survived calls for his resignation amid revelations that lottery retailers and other insiders had won a disproportionate number of jackpots at the Ontario Lottery and Gaming Corp.

But there may be hope of a cabinet comeback for Caplan, whose mother Elinor also served as health minister under a previous Liberal government.

Broten's promotion came as a surprise to some who saw her dumped from cabinet after she irked neighbours with plans to tear down a old tree at her Toronto home to make way for a two-storey garage when she was environment minister.

"I think the best politicians are good students and they learn their lessons and they find ways to grow and to develop ever better abilities, and that's what I'm looking for," McGuinty said.