No, not at all. I will pick up from here.
In our next slide, we note with interest that in paragraph 2.77 of the report of the Auditor General calls for a better definition of applicants who present a danger to public health.
I would suggest that, from many of the tables and committees on public health that I've participated in over the years, I've heard that Citizenship and Immigration Canada has expressed interest in reviewing the medical screening process. On behalf of all public health practitioners in Ontario, I would strongly encourage that this review be undertaken as soon as possible.
Such a review, I think, would have the benefits of not only defining the applicants who present a danger to public health, but also would address a system efficiency by considering the impact of such definitions on the whole system—both the health care system that Natasha spoke to, and public health, excluding those issues that are no longer relevant, such as syphilis—and supporting the appropriate use of health care resources and public health resources as well.
I would like to focus on two particular points—on tuberculosis and that which occurs at the local public health unit. Over the last several years, we have studied what we have been asked to, as part of the medical surveillance process concerning tuberculosis, and have come to the conclusion that, in fact, it's too much effort on the part of local public health for not enough benefit.
We would strongly encourage that the system require some review that should be evidence-informed, and should take into consideration the perspectives of local health care providers and public health providers, to ensure that the objectives of the medical screening process are actually being met, and being met in a cost-effective and efficient manner.
Finally, I'd like to draw your attention to the timing of medical examinations under the medical screening process. As I'm sure you're aware, the medical examination, the immigrant medical exam, is valid for one year. I think one does have to wonder, or at least question, whether this makes sense if the individual has continued exposure to some of the diseases in question, for example, tuberculosis, while waiting for the results of the immigration application overall.
On the other hand, on the issue of timing, we would also suggest that there could be streaming of the process, particularly for those who are already in Canada. I can tell you of countless stories of individuals who had just completed the medical surveillance process for example, as a temporary worker or student, and who then decided to change their status to immigrant or permanent resident, and were asked to undergo the entire medical surveillance or medical screening process de novo. We think that there are opportunities, certainly, for efficiencies in an examination of the system.
With that, we'll bring our remarks to a close. We’ll be happy to take any questions you may have for us.