Mr. Speaker, I rise to participate in this debate on motion M-285 requesting mandatory HIV screening for immigrants and prescribed classes of visitors.
Section 11 of the Immigration Act states that every immigrant and every visitor of a prescribed class shall undergo a medical examination. The medical examination required under Section 11(1) is defined in Section 11 as including a mental examination, a physical examination as well as a medical assessment of records respecting the immigrant or visitor.
Section 19 lists the classes of inadmissible persons, from terrorists and war criminals to persons convicted of an offence committed in Canada or outside Canada and so on.
In its present form, the motion tabled by my colleague the Reform Party member for Calgary Northeast therefore intends to bar entry to immigrants and visitors who are HIV-positive or have AIDS. In his opinion, this medical condition should be listed in Section 19 of the Immigration Act.
The minister of immigration has already stated that it was currently possible for Canada to disqualify applicants who are H.I.V. positive or have AIDS. In 1993, 54 applications were rejected on those grounds. A medical officer needs only suspect such a condition for an AIDS test to be performed. If the diagnosis is positive, then two medical officers must agree to recommend that the application be rejected by government.
The minister told the press that the reason for refusing in such cases is not the danger for public health but the financial burden it would impose on Canada's health care system. This provision would also be used to refuse admission to people with other diseases that require very costly medical care, like some cancers, kidney or heart diseases.
The minister himself also pointed out that it would be important to ensure the reliability of tests in different countries before making the tests compulsory. As for refugee claimants, who must undergo a medical examination within 60 days of arriving in Canada, the minister surely considers it a sensitive issue, because he said that on one hand there are medical considerations and on the other a real fear of persecution.
This issue is also tied to human rights. The Department of Justice should look at this aspect of the issue before making a final decision on this.
Immigrant selection based on AIDS screening is a matter for public debate. One of the arguments put forward in this debate is that excluding HIV-positive immigrants would limit transmission of the virus and reduce health-care costs associated with the treatment of immigrants with AIDS.
To determine whether a specific minority of immigrants constitutes a financial burden on the public health-care system, we must look beyond the costs related to a particular disease. The economic burden for a given disease must be compared with that for other existing diseases on the basis of which immigrants are selected or rejected. This, of course, for the purpose of developing an immigration policy that is sensible, fair and, above all, free from any hint of discrimination.
A group of researchers at the McGill Centre for Medicine, Ethics and Law in Montreal recently published a study comparing the cost of treating AIDS patients and the cost of treating coronary disease. In their study, the researchers used a model to project costs directly attributable to AIDS and coronary disease over the ten-year period following the arrival of immigrants who entered Canada in 1988.
The model has three components: first, estimating the cost of screening immigrants for AIDS; second, estimating the cost of treating immigrants with AIDS; and third, estimating the cost of treating immigrants suffering from coronary disease.
The results of the study may come as a surprise to some people. It is estimated that after ten years, the total direct cost of HIV-related health care would be $18.5 million. Over the same ten-year period, the total cost of treating immigrants suffering from coronary disease would be $21.6 million.
There is no effective screening method for detecting an increasing risk of developing clinical coronary heart disease. However, excluding all immigrants over the age of 50 years old would potentially save $14 million of the expected $21.6 million in cost attributable to coronary heart disease.
With regard to the reliability of the testing itself, we know it is not 100 per cent sure. In fact, three consecutive tests are needed to confirm positive HIV infection in a person. This process, time consuming and costly, will fail to detect close to 10 per cent of HIV carriers.
The study I am talking about assumed the testing to be done in Canada so that the false results could be reduced. How could the Canadian government possibly control the quality of testing in other countries? A similar problem produced itself in 1981 when
costly testing for intestinal parasites in prospective immigrants were abolished partly because of the inability to control the quality of testing in overseas laboratories.
All of these facts speak clearly against the introduction of AIDS testing of prospective immigrants and refugees. I have not even spoken about ethical considerations, which would seem just as important in the discussion. After all, applying a criterion for one disease and not for another is simply discriminatory. Testing for AIDS would also reinforce stereotyping and discrimination for prospective immigrants or refugees, whether it be in this country or the country they would be forced to return to.
The spreading of AIDS must not be labelled as originating from visitors or new residents to this country, but must rather be seen in its global context. In other words, if the Canadian government were to impose obligatory AIDS testing, how could it justify not spending an equal amount of tax dollars on educational programs aimed at preventing the spreading of this disease? Prevention is the only way to control AIDS, which is surely better than spending millions on a testing which gives absolutely no concrete results.
Mr. Speaker, for all these reasons, the Bloc Quebecois will vote against this motion.
For all these reasons the Bloc Quebecois will vote against this motion.