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Smitherman downplayed travel concerns, saying consolidation will be limited in remote areas and won't cause much trouble in urban areas. He noted the new Kensington Eye Clinic near College St. and Spadina Ave. has taken cataract surgeries from downtown hospitals just a few blocks away. "I don't believe there's any hardship." Unions warn that cleaning, laundry and other services will be contracted out to the lowest bidders, resulting in lower standards and wages, as the government tries to control costs in the $33 billion health−care system. Smitherman said the networks − including five serving Greater Toronto and outlying areas − will have to consult the public on changes to health service delivery within their boundaries. Instead of decisions being centralized at the health ministry, decisions will be made at open meetings under the scrutiny of the public, he said.

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