Citizenship and Immigration Committee on Oct. 24th, 2017

[The Chair, Liberal, Rob Oliphant]

I'm afraid I need to cut you off there, but I don't really want to, because I like your questioning.

Go ahead. Mr. Whalen.

[Nick Whalen, Liberal, St. John's East, NL]

Thank you very much, Mr. Chair.

I have to say that this is all very interesting. Thank you for coming and giving us this tutorial on how the medical exclusions work in the Canadian immigration system, but I have to say, from a moral perspective, that I feel very sheepish just even talking about it.

I don't know where the objective of the provision explicitly recognizes the sanctity of human life and the equality of all people in our immigration system. Doing a cost-benefit analysis in advance on human beings and whether or not they should be in Canada makes me very morally squeamish. When I look at this situation, I think these are horrible things to be measuring, so I'm sorry you guys have to go through this.

In terms of the overall broader Canadian population, how many sociopathic disorders have you guys seen in the applications, as compared to the number in the general Canadian population?

[The Chair, Liberal, Rob Oliphant]

Excluding present company.

[Voices]

Oh, oh!

[Nick Whalen, Liberal, St. John's East, NL]

I mean, there are measures for this. What percentage of the Canadian population has sociopathic disorder and what percentage of applicants are being excluded on that basis?

[Dr. Arshad Saeed]

Very few are excluded on that basis, and it's not based on the cost but on the threat to public safety. If they have any aggressive or violent behaviour, they are deemed inadmissible based on that, not on the cost.

[Nick Whalen, Liberal, St. John's East, NL]

In terms of active tuberculosis and untreated syphillis, do you have numbers for those compared to those in Canada? How many are being rejected?

These are the three that you've highlighted,so I assume that you might have done some extra digging on those items in deciding to present those three.

[Michael MacKinnon]

We do have data related to these items. On the numbers, the outright decisions of inadmissibility for these conditions are extremely rare, because the practice of the department is to, as we call it, “further”, or put on hold, the application.

An individual who is found to have active pulmonary tuberculosis by a medical examination in their home country is advised of those findings and also advised that we can put the application on hold while they get treatment for that condition. They can return, have a subsequent medical examination, and, assuming it finds that the treatment is successful, then they're admitted, but with the requirement to report to the provinces for medical surveillance, because there is a risk that the tuberculosis will become reactivated over their lifetime.

Again, the numbers of people found inadmissible for these causes are extremely small, and it would be—

[Nick Whalen, Liberal, St. John's East, NL]

When you were quoting these numbers back to us.... I know that we've been asking for rejections. Maybe you can also include the numbers of those on hold as well, so that we have a sense of how much the applications and the timelines are being impacted by these types of screenings, instead of their coming to Canada and being treated in Canada.

In terms of these averages, if a family of five is coming here, does each individual person have to meet the threshold, or does the family as a group have to meet a threshold that is five times the dollar value of this family of five, for instance?

[Dawn Edlund]

It's each individual.

[Nick Whalen, Liberal, St. John's East, NL]

Also, is the threshold based on the 2017 cost of services, or is it based on some point in time in the past? Is it a rolling forward or...?

[Dawn Edlund]

The majority of the costs annually comes from the Canadian Institute for Health Information. That's the one that's updated once a year. For 2017, that was $6,299. They look at the per capita cost of Canadians' usage of health and social services, they do the math, and that's the number they end up with. In 2017—

[Nick Whalen, Liberal, St. John's East, NL]

Canadians have this big, broad curve of costs of medical care, and here's your average point, and anyone who wants to be an immigrant to Canada has to be basically—I mean, there are all these other things—in the top 50%. We're not going to take immigrants who meet the overall Canadian threshold and represent what Canada looks like from a medical cost perspective. We're only going to take immigrants that beat the Canadian average.

[Dawn Edlund]

Yes. It is the Canadian average—

[Nick Whalen, Liberal, St. John's East, NL]

Not only that, even within a family, a family might totally blow out the Canadian average, but if one of their members doesn't meet the Canadian average, then the family gets excluded.

[Dawn Edlund]

Yes.

[Nick Whalen, Liberal, St. John's East, NL]

Okay. I think my questioning is done.

[The Chair, Liberal, Rob Oliphant]

Thank you. Because you have a few seconds left, I would like to use them.

In your remarks, you say, “We recently undertook a cost-benefit analysis, using data from 2014 arrivals.” What did you count as the benefit? Of the cost-benefit analysis, I understand the costs. What were you counting as a benefit?

[Michael MacKinnon]

To be clear, for the cost-benefit analysis, the costs were largely the processing costs to the department, plus litigation costs and similar costs that were imposed on us. The benefit was the estimated savings to provincial and territorial health systems.

[The Chair, Liberal, Rob Oliphant]

Okay, so there's no benefit to society.... When I heard that in the remarks, I assumed that you had done something similar to Australia, to look at the benefit of immigration, as Mr. Whalen was just saying, but that has never been included.

[Michael MacKinnon]

No.

[The Chair, Liberal, Rob Oliphant]

Thank you.

Go ahead, Ms. Kwan.

[Jenny Kwan, NDP, Vancouver East, BC]

Thank you, Mr. Chair. I would like to follow up on other questions.

With respect to processing time for each of the categories involving cases of “excessive demand”, can you tell us the average processing time and tell us how many families have had to do more than one medical because of the long wait time in getting the application processed?

[Dawn Edlund]

Mr. Chair, we can have a look in terms of the processing times when medical inadmissibility is an issue that has been raised by the immigration medical exam, because there can be furtherances, and there can be—as my colleague alluded to—someone with active tuberculosis who goes through a period of treatment, and that counts against the application time. The treatment, which I'm not very sophisticated about—and Dr. Saeed could undoubtedly speak to this—takes place over the course of a period of time, and then the application is picked back up again. Part of it will depend on how quickly the individual applicants act in the medical furtherances. If there are further tests that are required from other specialists, then it's in their hands as to how quickly they do those tests.

I believe your second question about people redoing medical examinations would relate more to individuals who haven't been issued a visa yet. Their application is in process, they have a valid medical examination, and they have not yet been issued a visa. The medical results are good for a period of one year, and if they don't get the visa within that one-year period, then they have to redo their medicals.

[Jenny Kwan, NDP, Vancouver East, BC]

Could I get those numbers from the officials? If you can undertake to provide that information to us, that would be greatly appreciated.

I have two specific cases I'd like to bring to the attention of the officials just by way of a snapshot of the examples.

One is the publicized case of Mercedes Benitez. She made her application in 2010. She has been waiting seven years for it to be processed. Her case involves a son who has an intellectual disability, so it's not TB or anything like that. Her application has been in process for seven years.

I have a case of another individual, Monica Mateo. She made her application in 2012. It's been five years since she made the application, and again it's not a contagious disease or anything like that with respect to her daughter. In fact, in her case, her employer has even offered to cover all expenses related to her daughter if there were excessive demands determined. Her employer has submitted her bank statements for verification. They are still waiting.

There is something wrong with our system in the way we are treating such individuals.

When the officials say that this is not an issue around discrimination and that people's rights are not being violated in accordance with our charter, the question I want to put to the officials and to the government is this: is not the process you are making people go through because of their disability deemed to be a violation of our charter? Any other person would not have to undergo this process. Only people with disabilities have to undergo this process. That is the argument the associations working with people with disabilities are advancing.

I'd like to have the officials comment on that.