Citizenship and Immigration Committee on Oct. 24th, 2017

[Dawn Edlund]

On specifically the medical side, we'll see if we can get that.

[Randeep Sarai, Liberal, Surrey Centre, BC]

I would also like to know how many of them get approved.

[Dawn Edlund]

Yes.

[Randeep Sarai, Liberal, Surrey Centre, BC]

I'd like to see the ratio in how many people apply.

My understanding is that very few who apply for discretion ever get through, nor do their mitigation plans ever get approved. I'd like to know the percentage, if you could get that in a timely manner.

Are there other countries that have a bond or mitigation guidelines that have been considered successful, specifically in western or developed countries, perhaps Australia?

[Michael MacKinnon]

We'd have to explore that more.

[Dawn Edlund]

We'd have to look into whether other countries like Australia or New Zealand have mitigation plans as part of the way they do medical admissibility decision-making.

[Randeep Sarai, Liberal, Surrey Centre, BC]

Then you're not aware of any that do that?

[Dawn Edlund]

No.

[Randeep Sarai, Liberal, Surrey Centre, BC]

No.

My colleague asked this earlier.

I understand that if a live-in caregiver's family member has a disability, they would be excluded, barring any mitigation. However, you're saying that a family class would not be excluded. What about other economic categories or economic immigrants? Would the entire family be excluded if one person were considered inadmissible under these guidelines?

[Dawn Edlund]

It's the balance that we try to strike between humanitarian considerations and family reunification. That is why certain categories of applicants are exempt from the provision, versus the concern about protecting social and health care services that are publicly funded. It's the balance between the two.

Every economic immigrant who applies to come to Canada with his or her family will be medically assessed. They will go through immigration medical examinations. They will be assessed. If one of them is found to be inadmissible, they don't benefit from that same exemption as the close family class members for the family reunification purpose.

[Randeep Sarai, Liberal, Surrey Centre, BC]

I'll pass.

[The Vice-Chair, Conservative, Michelle Rempel]

For the record, I did want to give you an extra 10 seconds.

[Randeep Sarai, Liberal, Surrey Centre, BC]

The previous chair was more liberal.

[The Vice-Chair, Conservative, Michelle Rempel]

Quite, indeed.

Mr. Maguire, you have the floor.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you, Madam Chair.

I just want to check again on the provisions that you have here.

You mentioned that approximately half a million medical exams are performed annually by IRCC. Does that mean that a half a million individuals have applied? Is there one exam per individual, or are there multiple exams for individuals?

[Dawn Edlund]

For example, if a family were applying to come to Canada, all the family members would go through the immigration medical exam. It's not a case; it's the entire family.

That number of 500,000 to 550,000 medical examinations goes up and down year over year, depending on the number of applicants, depending on how many temporary residents need to go through the medical examination process, etc.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Mr. MacKinnon, maybe this is what you were referring to, but can you provide a bit more expansion on the definition of “excessive demand”?

[Michael MacKinnon]

I have two pieces of paper on the definition of “excessive demand”, and I have the legislative provision. The regulations specify that it is:

A demand on health or social services for which the anticipated costs would likely exceed average Canadian per capita health services and social services costs over the period of five consecutive years immediately following the most recent medical examination.

The definition of “health services” is:

health services for which the majority of the funds are contributed by governments,...services of family physicians, medical specialists, nurses,...physiotherapists.

Social services, in the regulations, are:

any social services, such as home care, specialized residence and residential services, special education services, social and vocational rehabilitation services, personal support services and the provision of devices related to those services,

(a) that are intended to assist a person in functioning...; and

(b) for which the majority of the funding...is [provided] by governments....

It's a very specified basket of services that we're looking at. To interpret that, they're the ones directly related to medical diagnoses.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you.

If you were looking at a situation in which a person or child was physically disabled and had some mental incapacities as well, and they required a teacher assistant full-time, would that automatically be a situation in which you would reject that applicant?

[Michael MacKinnon]

I'll forward that question to Dr. Saeed, because he conducts the medical assessments on those sorts of facts.

[Dr. Arshad Saeed]

Once again I'll say that it's not the disability or the condition that will render them inadmissible. We look at the severity of the diagnosis and the frequency with which they will require those services. If an extra teacher is required, yes, that will increase the cost of social services for that particular applicant. If they require speech therapy, occupational therapy, or other therapies on a regular basis, that can potentially make them inadmissible.

[Larry Maguire, Conservative, Brandon—Souris, MB]

And therefore the whole family would be rejected.

[Dr. Arshad Saeed]

That's correct.

[Larry Maguire, Conservative, Brandon—Souris, MB]

This is a situation that I think arose in my office before I became a federal member of Parliament. It is a situation in which I believe a whole community ended up looking at the net benefit to having this person in their community. I know we've talked a little bit about the net benefit here, and I understand that it's a bit difficult to calculate, but this whole community—just about every community organization—wrote letters of support for this individual. The situation was very much accepted.

One reason they did that was that the community I come from is a mainly rural area with a very serious shortage of nurses, and the mother of this child was a very qualified nurse. The need for her in the hospital was greater than the cost of the rest of the care that this person was going to have to have. Eventually we were successful in keeping this family there. They have three other children, who are quite normal, in the school. There's all that to be taken into consideration.

I'm just wondering if there's any movement to look at the idea that maybe there's not just a hard and fast net dollar cost but a social net benefit to having a person of this type in a community as well.

[Dawn Edlund]

We do have a bit of a process that's used on an ad hoc basis, particularly for provincial nominee cases. The province will come forward to us with exactly the kind of situation you're describing: that there's someone in a rural community who is very important to them, to their economy, to the health services that are provided to the community. They will write a letter to the department, saying, “We recognize that there may be medical admissibility issues and excessive demand. We're telling you we fully support this individual and the family in our community.”

That's then put in front of our decision-making officers. Frequently at that point the family ends up with a temporary resident permit. Once they're on a temporary resident permit for three years running, they can be granted permanent residency, with no further look at the medical admissibility.

We do have that process now. Provinces will come forward with those letters of support.