Four years after a landmark report raised the alarm about the care of reservists, the military ombudsman says citizen soldiers are still treated poorly and not given periodic health assessments or consistent immunizations.

Pierre Daigle also concludes there remains a wide gulf between the cash settlements reserve members and those in the regular force receive when they lose a limb on duty in Canada.

Daigle released a new report Wednesday that says out of the 12 recommendations made in 2008, only four have been fully implemented, another six were partially achieved and two have seen no action whatsoever.

The ombudsman's office was told by the Harper government at the time that it accepted all of the recommendations.

"I was expecting a better average in the implementation," Daigle said in an interview.

"Everything there was not that difficult to implement. There still seems to be two classes of soldiers in the Canadian Forces, and this is disappointing."

The new report looks at the care reservists are given within Canada, not on overseas missions, which are subject to a different set of criteria.

Minister's office says progress has been made

Jay Paxton, a spokesman for Defence Minister Peter MacKay, challenged the suggestion that little has been accomplished and said that National Defence has been working — and made progress — on 10 of the 12 original recommendations.

But Daigle points out there is still no overall health-care framework for reservists, who throughout the Afghan war made up an increasing number of the battle groups sent into the field to fight the Taliban.

The report notes that the insurance plan that compensates soldiers for losing limbs has not been amended — a fact the ombudsman calls "unfair and inequitable" and something MacKay needs to address right away.

Under the existing plan, a reserve member receives only 40 per cent of what full-time soldier gets for the same dismemberment.

Investigators in the ombudsman's office who tried to examine why the recommendation for change was ignored found themselves facing a brick wall when documents covering negotiations with the Treasury Board were deemed cabinet confidences by the government.

The ombudsman was able to determine that the chief of military personnel asked the Harper government to make the change, but it remains unclear why it was not acted on by Treasury Board.

MacKay's spokesman said the issue of accidental dismemberment will be addressed.

"The fact that the Department of National Defence and the Canadian Armed Forces have not implemented necessary changes to the Accidental Dismemberment Insurance Plan is completely unacceptable," said Paxton.

"Minister MacKay has directed officials to resolve this outstanding, unfair issue immediately and to inform Canadians and Canadian Forces reservists of the necessary changes once they are finalized."

Reserve commanders don't know who's fit to deploy: Daigle

The lack of periodic health assessments poses a risk to the military, Daigle said.

It means reserve commanders have no idea whether their troops are medically fit to deploy on domestic operations or whether they face health restrictions.

National Defence in 2009 clarified what medical care reservists are eligible to receive, but Daigle points out it has been poorly communicated to the troops.

The ombudsman found that the message was distributed to the air force and navy, but the army, which has the largest number of reserve troops, couldn't confirm everyone within its ranks got the message.

Paxton suggested the ombudsman's latest report presented an unbalanced picture of what the government has tried to do.

"Minister MacKay has consistently stated that the care of ill and injured personnel is his central priority," he said.

"Not reflected in the ombudsman's report are the monies Minister MacKay reallocated from within his budget, a total of $11.4 million, to augment mental-health care and preventive programs for regular and reserve Force members.

"This initiative brings the Canadian Forces annual mental-health care budget to $50 million and provides better mental health care to reserve personnel."

He also noted the government has invested in a pension plan for reservists and in improved medical record keeping.