TORONTO -- Ontario's ombudsman is warning the governing Liberals that unless they live up to their promise to protect patients by regulating non-emergency medical transfers soon, he'll be forced to re-open his investigation of the industry.

About 400,000 people are transported every year in privately owned vehicles that look like ambulances, ombudsman Andre Marin said Tuesday. But nothing's been done to regulate the sector for two years.

"This is a case where the wheels are literally falling off the bus," he said after releasing his annual report.

"Some of these vehicles, parts are flying off them. We have patients falling off gurneys. It's a question of time before there is a major catastrophe."

Marin said he agreed not to publish his report in 2011 after Premier Kathleen Wynne -- then transportation minister -- and Health Minister Deb Matthews agreed that the industry needed to be regulated. The coroner's been asking for regulation since 1995, he said.

He recently reminded Wynne of her promise, he said. But Transportation Minister Glen Murray wasn't even aware of the report.

"Since 1995, the government has a history of panicking when the issue comes up -- when there's a crash and someone gets injured or someone gets killed," Marin said.

"And then as soon as the media fades, the government's interests stalls in changing the legislation."

The Liberals are taking their responsibility of protecting Ontarians too lightly, said NDP health critic France Gelinas.

"They look, they feel, they come when you call the ambulance, but yet they're not," she said of the transport system. "They're set up to deceive people, and they do each and every day."

Matthews said she's still committed to regulating the sector.

"My ministry has been working diligently on a policy framework that addresses the quality and safety issues identified in the report," she said in a statement.

"We are consulting with industry, health care providers, consumers and their families, and updating the ombudsman on our progress."

But there's other "unfinished business" the Liberals have yet to act on, such as replacing an outdated law that resulted in a "massive" violation of civil rights during the G20 protests in Toronto three years ago, Marin said.

The Special Investigations Unit still doesn't have teeth to properly investigate police involved in cases of serious injury or death, he said.

"If the resolution is not followed with action, it's as hollow as a broken promise," Marin said.

Progress has been made on other fronts, such as dealing with operational stress injuries and suicide among Ontario Provincial Police officers, he said.

As in past years, Marin yet again urged the government to give him oversight of hospitals, nursing homes, municipalities, universities and school boards, as other provinces do. Former premier Dalton McGuinty told him last year that it was just a matter of time, he said.

Marin has had to turn away more than 2,500 complaints about those sectors last year, he said. It's become "an embarrassment."

"Ontario is a have-not province when it comes to accountability," he added. "We were very good for talking the talk, but not walking the talk."

When there were calls for his office to oversee hospitals, the government created 153 so-called "patient advocates," he said.

"More power to them," Marin said. "If they decide a hospital needs Wal-Mart greeters, go ahead and get them."

But that just muddies the water when it comes to accountability, he said. Many hospitals he saw had patient advocates whose first job was to "report on compliments," he said.

"An ombudsman isn't there to report on compliments."

His office received 19,726 complaints and inquiries in the past year, up six per cent from the year before, he said.

Most of the tales of bureaucratic bumbling didn't make headlines, he said.

They included government staff who wouldn't give a father his baby daughter's birth certificate without a signature from his wife, who died in childbirth.

A whistleblower led to the discovery that the province's long-term care action line lost more than 250 calls, he said. The government has identified 13,866 potential duplicate licence records, or "ghost licences," that have allowed some suspended drivers to stay on the roads.

"We have right now, as we speak, hundreds of people who are driving that are not supposed to be driving," he said. "Some of them are drunks that should be off the streets."

Marin launched a new investigation Monday into whether the government is doing enough to protect children in unlicensed daycares, after a toddler died at a home daycare north of Toronto last week.

Education officials have admitted that they failed to follow up on two of three complaints lodged against the daycare.

Two Ministry of Education employees have been suspended, said Lauren Ramey, a spokeswoman for Education Minister Liz Sandals. An internal investigation is ongoing.