Citizenship and Immigration Committee on Nov. 22nd, 2017

[The Chair (Mr. Robert Oliphant (Don Valley West, Lib.)), Liberal, Rob Oliphant]

I'm going to call to order the 86th meeting of the Standing Committee on Citizenship and Immigration as we continue our study on the federal government's policies and guidelines related to medical inadmissibility of immigrants. We thank the minister and the officials for joining us.

We're partway through the study. We've had some officials here before, as we opened our study, and we've heard witness testimony over the last two days. We're delighted to have the minister here for his thoughts, as well as help from the officials.

Thank you for agreeing to come to see us today.

Minister Hussen.

[Ahmed Hussen, Liberal, Minister of Immigration]

Thank you, Mr. Chair and members. It's always good to be back before the committee to share with you our perspective.

It is a pleasure to appear once again before this committee.

The government appreciates the committee's decision to undertake this study.

As you know, Immigration, Refugees and Citizenship Canada has undertaken a fundamental review of the excessive demand provision, and we've consulted with provincial and territorial governments. As I have openly stated to my provincial and territorial counterparts, this review is necessary and long overdue.

To put it into perspective, this provision has been in place for more than 40 years. From a principled perspective, the current excessive demand provision policy simply does not align with our country's values on the inclusion of persons with disabilities in Canadian society. The current objective of the provision is to strike a balance between protecting publicly funded health and social services and facilitating immigration to Canada, while also supporting humanitarian and compassionate objectives in Canada's immigration policy. But there is now a recognized need to realign the policy, to also make it more fair and inclusive of persons with disabilities.

As you know, Mr. Chair, to begin our review of this policy, our government launched consultations with provinces and territories in October 2016. Departmental officials also engaged stakeholders, including disability advocates.

The results of these discussions, together with consideration of public perspectives, judicial decisions, and media reports, as well as this committee's recommendations, will inform the development of options to be presented for decision by the government.

As my officials indicated previously to this committee, the health inadmissibility provisions are designed in part to reduce impacts on Canada's publicly funded health and social service systems. While a number of policy principles underpin our review of the excessive demand provision, these include the need to continue to protect health and social services.

That being said, the numbers we are talking about are incredibly small.

As my officials indicated, a cost-benefit analysis found that the total number of decisions on excessive demand made in a single year will result in an estimated savings of about $135 million over a period of five years of projected health care coverage. That amount represents just 0.1% of all provincial and territorial health spending in 2015.

Since our initial discussions, we have shared potential areas of change with provinces and territories. These have included possible adjustments to the cost threshold, changes in the groups exempted from the provision, redefining the services under consideration, or enhancements in how wait-lists are considered.

This information will give provinces and territories the opportunity to assess these options and the potential impacts on their jurisdictions.

As we agreed in September at our federal, provincial, and territorial meeting of ministers responsible for immigration, we are committed to ensuring that the policy continues to recognize the need to protect health, social services, and education while treating applicants fairly. In particular, our government wants to ensure that the implementation of this policy aligns with our values regarding the inclusion of persons with disabilities into Canadian society.

Once again, I appreciate that the committee has chosen to undertake a study of this really important and sensitive policy.

The government is eager to receive your recommendations.

I look forward to answering your questions.

Thank you.

[The Chair, Liberal, Rob Oliphant]

Thank you very much, Minister, and thank you for your brevity, which gives our committee a lot of time to ask questions of you.

We will start with Mr. Tabbara, from the Liberal Party.

[Marwan Tabbara, Liberal, Kitchener South—Hespeler, ON]

Thank you, Mr. Chair.

Thank you, Minister, for being here today.

Minister, in this study we've had individuals come here and share their testimony. One individual was a caregiver. Another individual was a professor at a university. In both cases, they have lived in Canada and paid their fair share of taxes. They felt as though they were good enough to work here, but they weren't good enough to stay. It was hard to hear some of their testimony, because they felt that Canada is not welcoming and is splitting their family.

From ongoing testimony, we feel that there is a two-tiered system. I was wondering if you could elaborate on that and on how we can be more welcoming and how we can strike a balance between allowing these individuals to be here with their families—because they've contributed so much—and health care providers.

[Ahmed Hussen, Liberal, York South—Weston, ON]

Thank you. That's a really important question.

Before I answer the question, I want to say that Canada has an excellent settlement and integration program, which is the envy of the world, not only because of the government's efforts but also because we have a very welcoming society. Canadians are open to welcoming and embracing newcomers.

I think the reason you hear about these cases, the cases we know about and the ones that don't make it into the media, is that they raise issues around fairness. This is precisely why we've decided to launch a fundamental review of this policy. It's why we are making sure we hear from everyone about how best to move forward with the underlying reasons for the policy, but also bringing it into the 21st century and making sure that the excessive demand policy aligns well with what Canadians expect in terms of the inclusion of everyone in Canadian society.

That is why I'm very eager to get the recommendations and the feedback from this committee on ways to move forward on this. The cases you highlight do raise issues around fairness, and this is precisely why we need to review this policy: to make sure it's in line with Canadian values.

The final point I'll say about it is that this policy has been in place for more than 40 years. We're doing something that no other government has attempted to do, which is to look back and say, “Okay, how can we bring this policy up to Canadian values on how we include people?” We're doing the right thing; it's just making sure that we do it right, and to get it right, we have to hear from the committee, as well as from provinces and territories that are impacted by any possible changes to this policy.

[Marwan Tabbara, Liberal, Kitchener South—Hespeler, ON]

I want you to elaborate a bit on fairness. I don't think this review is looking at “family” as a unit. I want to ask you about that. When we look at this review and we're looking at policy changes, are we going to be looking at families as units and at their contributions to the greater Canadian society?

[Ahmed Hussen, Liberal, York South—Weston, ON]

First of all, I think the committee is open to looking at this policy from their own perspective and coming up with their own recommendations. I'm certainly open to that.

Secondly, I want to reassure you and the committee that all options are on the table with respect to moving forward on this policy. You have my word on that. If you think we should have a more comprehensive look at the contributions of family, that is certainly something you can put forward.

The only contribution I'll make to that suggestion is to say that Australia moved forward on that approach, and they weren't able to succeed. They weren't able to succeed in terms of looking holistically at families.

[Marwan Tabbara, Liberal, Kitchener South—Hespeler, ON]

In regard to humanitarian and compassionate grounds, a lot of testimony was provided. We heard that for individuals to be approved, this avenue is very difficult. One of their family members may have been inadmissible to Canada, and their next option was to apply on humanitarian and compassionate grounds. Some were successful, but very many others weren't. Can you elaborate on that?

[Ahmed Hussen, Liberal, York South—Weston, ON]

I'll let my official answer that question.

[Dawn Edlund, Associate Assistant Deputy Minister, Operations, Department of Citizenship and Immigration]

In the material we presented to the committee, Mr. Chair, under the undertakings from our last appearance—specifically, undertaking number 15—we provided statistics to the committee that looked at immigration medical exams from 2013 to 2016: 224 people applied for humanitarian and compassionate consideration, and 91% of them were successful.

[Marwan Tabbara, Liberal, Kitchener South—Hespeler, ON]

Okay. Never mind, then.

Finally, can you update the committee on the department's ongoing work with provincial and territorial counterparts on medical inadmissibility? During all these testimonies, we heard a limited amount of testimony on provinces and territories.

[Ahmed Hussen, Liberal, York South—Weston, ON]

Before I let my official respond in detail to the question, I will say the consultations with provinces and territories have been ongoing. I met the ministers responsible for immigration at a federal-provincial-territorial meeting in Toronto, and this was at the top of our agenda. We had an in-depth discussion on how to move forward on this.

There was a variety of opinions around the table. Provinces and territories were very supportive of the review. They think we should look at this again. Some provinces are a little apprehensive about the costs they think they'll have to incur, but they do agree with the general premise that we need to bring this provision in line with our other accepted policies with respect to moving towards an inclusive approach towards people with disabilities.

[The Chair, Liberal, Rob Oliphant]

Thank you.

I'll let the official respond and—

[Ahmed Hussen, Liberal, York South—Weston, ON]

That's okay.

[The Chair, Liberal, Rob Oliphant]

Okay? Very good.

Ms. Rempel.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you, Mr. Chair.

Well, Minister, I think for once we agree on something. Our immigration policy shouldn't be ableist, but it also needs to be cognizant of the need to ensure the sustainability of our social programs. It's a balance in this situation.

We've heard testimony from quite a few experts in the field who have made some suggestions on low-hanging fruit, as it would be, in terms of ways to change the process. One of the things that came up yesterday was the fact that it's not so much the legislative framework around this issue but how the rules are currently being applied.

We've heard about dozens of cases where the rules were applied either unevenly or improperly, so I'm just wondering, have you, as part of the review, instructed your department at all to look at perhaps a new training mechanism or some sort of service delivery standard to ensure that department officials are actually following the law consistently and perhaps putting some more consistency frameworks in place to apply the rules in this situation?

[Ahmed Hussen, Liberal, York South—Weston, ON]

That's a good question. No, I haven't done that, because my position has been very clear from the beginning that this provision needs to be changed. It's simply not in line with our government's policies with respect to moving towards an accessibility agenda, and also with how Canadians are increasingly of the opinion that we should be more inclusive as a society. I personally think this provision is out of date in terms of looking at those two things—

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Are you suggesting then that there would be no framework for this and that it would be removed entirely?

[Ahmed Hussen, Liberal, York South—Weston, ON]

No, that's not what I'm suggesting. I'm suggesting bringing the policy in line with where Canadians are today.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

What does that mean?

[Ahmed Hussen, Liberal, York South—Weston, ON]

It means being more inclusive and being more fair and addressing issues around fairness.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

So how in terms of a legislative change...? You've just said you're not looking at process change, and you're saying that currently there are issues with the legislative framework, so what legislative changes are you proposing?

[Ahmed Hussen, Liberal, York South—Weston, ON]

Look, the changes we will make depend on the feedback we get from stakeholders, the provinces and territories, and this committee.

We're not there yet.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you.

One of the common denominators in feedback that this committee has received is the application of the rules being inconsistently delivered by your department. Being presumptive and assuming there would be some sort of framework even after the results of your review, what is your department doing to ensure that.... There seems to be a friction point with service delivery on this, and part of what immigration lawyers have told us themselves in cases is that they don't know what the criteria are and also that they're being applied unfairly.

We've heard them say that procedural fairness levels are difficult to understand and that most people who want to challenge a finding of medical inadmissibility feel they must hire a lawyer. One of the recommendations that have come up many times is that your department could be simplifying the language in these letters.

Regardless of what the legislative framework changes, it's clear that there's also a service delivery issue. Have you instructed your department to look at those friction points at all as part of your review?

[Ahmed Hussen, Liberal, York South—Weston, ON]

I haven't instructed my department to do so. What I can update you on is that my officials have told me they are looking at process improvements in terms of how those decisions are made and how the applications are being processed. They also welcome advice from this committee as we move forward. That's where we are right now.