The Canadian military's failure to keep track of whether its health-care staff have maintained their licences and certifications after enlisting may have resulted in unlicensed physicians and nurses providing direct patient care to soldiers, the auditor general said Tuesday.

"All regulated professionals, both military and civilian, are licensed and certified before they are hired" by the Department of National Defence, said Sheila Fraser's latest report to Parliament.

"However the department does not monitor its military health-care practitioners once employed to ensure they maintain their licences or certifications and are in good standing with a regulatory body."

Fraser's report also found many military medical staff are not keeping up with advancements in the health-care field or taking advantage of offered skills-maintenance courses because "they believe they cannot be spared from regular duties."

"National Defence does not have some of the basic information we would expect to see in a well-managed system of heath care," Fraser said.

Shortages in mental health programs

Fraser said at a minimum, the Defence Department should know the professional status of each of its 2,275 regular force health staff.

The Defence Department estimated in 2006 that as many as 20 per cent of its military health care providers may not have been licensed.

In the course of her audit, Fraser's staff tried to do their own their own survey, asking military doctors to show proof of their licences. Of those who responded, 69 per cent were able to show they were registered with a provincial college of physicians and surgeons.

The auditor general also found the military was adapting its mental health service model to address growing needs based on best practices, but has not been able to staff the service fully with all the required professionals.

"Due to this resource shortage, the system cannot meet all the demands for mental health services," the report said. "As a result, members are being sent to the civilian private practitioners where it is difficult for the department to monitor their care."

Fraser also said there are resource shortages to the mental health services offered to military families.  

NDP public works critic Charlie Angus said the report showed the government hasn't been doing enough to help service members with their mental health needs as they return from draining deployments such as the NATO-led mission in Afghanistan.

"To me, one of the most upsetting issues was the lack of a plan for health care for our soldiers coming back from Afghanistan, people who are suffering from post-traumatic stress disorder," Angus told CBC News on Tuesday.

Roughly 15 per cent of soldiers report post-deployment symptoms suggestive of one or more mental health problems, such as depression, post-traumatic stress disorder, and various anxiety disorders, said Dr. Mark Zamorski of the National Defence Medical Centre.

"It's important to keep in mind that most of our soldiers who return from a deployment, even from a difficult mission such as Afghanistan, will do just fine," Zamorski told CBC News on Tuesday from Ottawa.

He cited the post-deployment screening programs and better efforts to educate service members, their colleagues and families about mental health concerns as examples of how the system has improved in the last decade.

Military health-care cost to rise with 'high tempo' missions, expansion

The Defence Department spends more than $500 million annually to deliver health-care benefits and services, with the annual cost expected to rise with the planned expansion of the military and the "high tempo" of current operations, said Fraser.

She also said the military spent, on average, $8,600 per member, almost double the national average. The audit found that several payments for physician-on-contract services were difficult to verify because the Defence Department didn't have sufficient information.

The report said the Defence Department has agreed with the auditor general's recommendations and is taking action to address the concerns raised.

Despite the auditor general's concerns, a survey found that most of the military's 65,000 members and their families are satisfied with the care they received at 37 facilities across the country.

In her seven-chapter report released Tuesday, the auditor general also highlighted weaknesses at Canada's border agency, which she said allowed many potentially dangerous people and goods to slip into the country earlier this year.

The report also said the federal government is lax when it comes to handing over secret government information to private contractors who do not have proper security clearance, and is ignoring some of its responsibilities under the Western Arctic land claims deal it struck with the Inuit 23 years ago.

The position of auditor general was created in 1977 to act as a government watchdog. The auditor general is tasked with reviewing government spending and weighing in on how the government's policies are implemented.

With files from the Canadian Press