Thank you, Mr. Chair.
My name is Michael Battista, and I'm joined by my colleague Adrienne Smith, from Jordan Battista LLP.
We really consider ourselves, among the bar, as being medical inadmissibility specialists. We do a lot of this work. Our expertise really started in dealing with cases of applicants with HIV, but it has now expanded to cover a broad range of health and social services. Medical inadmissibility files are about 20% of what our office does, and I wanted to start off by talking about wait-lists for a moment.
Wait-lists are a little bit of a red herring. We have seen hundreds of procedural fairness letters in our office, and I can't think of one letter that has relied on wait-lists, or increase in wait-lists, to justify a refusal on medical inadmissibility grounds. Part of this is the problem the government has in justifying, or pointing to an applicant who would significantly increase a wait-list such that it would increase morbidity or mortality of Canadians.
Our main point is that paragraph 38(1)(c) is not sound public policy, and this is aside from the constitutional issues. This is aside from the anguish that it causes people. I want to reiterate what Mr. Waldman was referring to before. If we just look at cost alone, it's very questionable that this provision actually saves money. If we look at fixing the provision, the provision will be very expensive to fix.
First of all, let's look at the unlikely cost savings. Let's take the high-water mark of $27 million. That's the figure government witnesses were using to say what the savings were. We have really strong concerns about this figure. We think it is artificially high, but for the sake of argument, let's use the $27-million figure. We urge the committee to look at the costs of enforcing and administering this provision, and to take that into account to see whether there is, in fact, a net savings in administering and enforcing this provision. This provision really deals with layers and layers of government administration and decision-making.
I'm going to give you some costs that you might want to consider. One is the cost of panel physicians, worldwide, who are the first assessors of this information. There's usually a back and forth between family doctors and panel physicians. There are regional medical offices. There's the central medical admissibility unit here in Ottawa that's responsible for preparing the procedural fairness letters, researching costs. There are visa officers who have to deal with whether to uphold the findings of the central medical inadmissibility unit. These visa officers not only make those decisions, but they often have to deal with requests for waivers on humanitarian and compassionate grounds. They deal with requests for temporary resident permits. All of those costs have to be factored in.
In our office, we challenge these findings on a regular basis. There are also the costs of proceedings before the immigration appeal division. There are costs in Federal Court. When you're in litigation, costs rise dramatically.
I urge the committee to consider all of these costs, weigh them against that $27-million figure, and really determine whether, in fact, this figure is saving public resources. Our feeling, our gut instinct, is that there are actually probably very little savings here, and in fact, there's probably a net cost in terms of public resources.
I'm going to touch on the mitigation plan. Mitigation plans are done by applicants. They frequently pay us to construct these mitigation plans for them. They're really designed to ensure the government knows that a particular applicant won't access the services that are feared to present an excessive demand. The problem with these mitigation plans is that they basically disappear. They evaporate after a permanent resident becomes a permanent resident, so there's no enforcement at all of these mitigation plans even though they're relied on heavily to approve permanent residence for applicants. It's entirely possible that individuals who have been approved on the basis of a mitigation plan for whatever reason—for a change of circumstances, for instance—actually access those resources the government has assumed they wouldn't access. There's very little recourse from this.
We are not advocating that an enforcement scheme be put into place to enforce these mitigation plans, because I think that would just cost more public resources. Any time you set up an enforcement scheme, you're just sinking public dollars into a system.
Overall, I think it's very questionable whether this provision saves the government any money. I think it's probably more possible that it's costing the government money and the mitigation plans are very ineffective in assuring the government that excessive demands are not accessed.
I'm going to turn it over to Ms. Smith to talk about procedural fairness letters.