Evidence of meeting #86 for Citizenship and Immigration in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was policy.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Dawn Edlund  Associate Assistant Deputy Minister, Operations, Department of Citizenship and Immigration
Arshad Saeed  Director, Centralized Medical Admissibility Unit, Migration Health Branch, Department of Citizenship and Immigration
Michael MacKinnon  Senior Director, Migration Health Policy and Partnerships, Migration Health Branch, Department of Citizenship and Immigration
Madalina Chesoi  Committee Researcher

1:05 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

We haven't looked at the immigration patterns resulting from the elimination of the policy.

In terms of the cost question, I'll ask Ms. Edlund to respond to that.

1:05 p.m.

Associate Assistant Deputy Minister, Operations, Department of Citizenship and Immigration

Dawn Edlund

Go ahead, Michael.

1:05 p.m.

Michael MacKinnon Senior Director, Migration Health Policy and Partnerships, Migration Health Branch, Department of Citizenship and Immigration

As we indicated previously, we've provided an estimate of the dollar cost related to the specific individuals who have undergone the assessment for a given set of representative decisions. It's difficult to estimate. As I understand it, from what the committee members have described, and you've heard both sides, the estimate may be too high or too low.

Certainly at the level of officials, when we were in discussion with the provincial and territorial departments responsible for immigration, in a number of cases the provincial officials raised the issue that we were not considering the potential of a deterrence effect. That was because we were unable to assess that through an evidence-based approach. It's hard to tell, therefore, whether or not elimination of section 38 in its entirety or just paragraph 38(1)(c) would have a significant impact.

1:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

I'm sorry, I have a couple of more questions—

1:05 p.m.

Liberal

The Chair Liberal Rob Oliphant

You have 13 seconds.

November 22nd, 2017 / 1:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

When a potential immigrant is deemed to have an excessive demand on the health care system, there are various ways that you can appeal, such as putting forward a mitigation plan. A provincial-territorial authority could say that they fully accept the financial responsibilities, and you as the minister have the ability to waive that excessive demand clause on humanitarian grounds.

Mr. Minister, I'm just wondering if these avenues are still good enough to ensure that Canada is able to attract the highly skilled immigrants that we are after.

1:05 p.m.

Liberal

The Chair Liberal Rob Oliphant

Very briefly.

1:05 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

I've already answered the question with respect to whether this affects our ability to attract highly skilled immigrants. In my opinion, I don't think that's the issue at hand here. I think the issue is one of fairness and an incompatibility with our values.

1:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Are the three mechanisms of appeal that I suggested valid and good enough?

1:05 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

Are you saying good enough to address...?

1:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

—to continue with the present program, and that gives you the right to have the ability to waive that “excessive demand” clause.

1:05 p.m.

Liberal

The Chair Liberal Rob Oliphant

I'm afraid I can't give you a chance to answer. I'm sorry.

Ms. Zahid.

1:05 p.m.

Liberal

Salma Zahid Liberal Scarborough Centre, ON

Thank you, Chair.

Thanks, Minister, for coming today, and thanks for undertaking the fundamental review of the “excessive demand” provision, because we have heard, in the testimony, how many families have to go through a lot of painful, emotional stress. I am one of them. Many years ago my mother-in-law's case of immigration was rejected because of medical inadmissibility.

We have heard testimony about the effort and the resources that are put into the mitigation plans when an applicant receives a letter warning them that they are facing a finding of medical inadmissibility.

Immigration lawyer Michael Battista said, “They evaporate after a permanent resident becomes a permanent resident”. He added that his phone charge is $4,000 to $5,000 to prepare a mitigation plan as it's labour-intensive and those fees don't include extras like expert medical opinions. He added that the system “does seem to be economically biased toward those who can afford the legal fees to fight the determinations.”

Roy Hanes of Carleton University said that this creates a two-tier system: those who can afford to hire legal help and to mitigate their costs, and those who cannot; and the latter more often find the door to Canada is closed.

Minister, can you please tell us what happens to these mitigation plans after they are accepted? I'm not suggesting enforcement of these plans, barring outright fraud. We heard that systemic tracking would be expensive and a bureaucratic nightmare. It does lead to these questions, though. What purpose do these mitigation plans serve? Are they achieving that purpose, and are they creating a two-tier entry into Canada?

1:05 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

Before I let Ms. Edlund answer the detail of the question, I'll say that the issues around fairness and around accessibility to a Canadian society base that are raised by this policy are precisely why we're studying it. It is precisely why it has raised the issues around fairness. It is why we launched the review, and it's why we thank the committee for studying the issue, because we think that will inform our approach moving forward to make it a fairer issue. As some members have indicated, they would even prefer it to be eliminated completely, and that is certainly one of the options.

1:10 p.m.

Associate Assistant Deputy Minister, Operations, Department of Citizenship and Immigration

Dawn Edlund

The concept of mitigation plans came into play after the Supreme Court of Canada decision in 2005, called Hilewitz and De Jong, in which the two individual applicants wanted to present evidence of how they could mitigate the cost of special education, in one example.

The Supreme Court of Canada said that we as a department need to listen to what those plans are, and understand them and evaluate them. It was after that we put the mitigation plan concept into effect in response to the Supreme Court's decision.

1:10 p.m.

Liberal

Salma Zahid Liberal Scarborough Centre, ON

Are they achieving their purpose, do you think?

1:10 p.m.

Associate Assistant Deputy Minister, Operations, Department of Citizenship and Immigration

Dawn Edlund

It's really hard to tell if they're achieving their purpose, because we don't track or monitor them after the fact. As I said the last time I was here before this committee on this study, we don't have any enforcement mechanisms possible to see whether or not someone has actually followed the plan they put forward. We don't have line of sight on that at all.

1:10 p.m.

Liberal

Salma Zahid Liberal Scarborough Centre, ON

Thank you.

Minister, we have heard examples of cases of medical inadmissibility that came to your office for appeal on H and C grounds. We heard of cases such as that of a caregiver, Mercedes Benitez, who received a waiver through this route. We also heard that there are many cases that don't receive media attention as Mercedes' case did, and that H and C appeals are an answer to a bad law.

I would like to ask this. When you receive an H and C medical inadmissibility appeal, and if you are overturning 90% of those decisions, does that speak to a deeper issue within the medical inadmissibility process?

1:10 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

First of all, in the case you referred to, it was an officer who made the humanitarian and compassionate grounds decision. It wasn't me. It was an immigration officer who made the decision.

With respect to the cases that receive media attention and the ones that don't, the fairness issues raised by these cases are the reasons we are where we are now.

I want to remind the committee again that this policy has been in place for more than 40 years. No government has changed it. We are moving ahead and we believe that now is the time to do so. It is precisely because of the heart-wrenching cases that have come up and that have been concerning to Canadians and to members of Parliament, including you. That is why we believe it's time to move forward on this policy, to bring it in line with our values.

1:10 p.m.

Liberal

The Chair Liberal Rob Oliphant

Thank you, Minister.

We have two minutes left in the meeting. With the committee's agreement, I'd like to give it to the analyst to ask the officials a point of clarification. Is that okay with the committee?

1:10 p.m.

Some hon. members

Agreed.

1:10 p.m.

Liberal

The Chair Liberal Rob Oliphant

Madalina, go ahead.

1:10 p.m.

Madalina Chesoi Committee Researcher

Regarding the drugs that are recommended on a prescription from another country, not all countries have the same generic drugs, and the prices are really different.

If a specialist recommends that a person take drug A, is there a possibility that generic drugs are also specified in that prescription so that when they come to Canada, and if they have access to the generic drugs, they are not penalized?

1:10 p.m.

Director, Centralized Medical Admissibility Unit, Migration Health Branch, Department of Citizenship and Immigration

Dr. Arshad Saeed

Thank you.

No, the drugs are recommended by the treating specialists, who are different from panel physicians or IRCC medical officers. The drugs are different in different countries. What we look at when we do the costing is the equivalent medication in Canada—

1:10 p.m.

Liberal

The Chair Liberal Rob Oliphant

Therapeutic substitution.