A person applying for immigration to Canada may be refused on health grounds – if their condition might reasonably be expected to cause excessive demand on health or social services. Following the publication of its November 2015 report, Evaluation of the Health Screening and Notification Program, Immigration, Refugee and Citizenship Canada began a review of its assessment process for cases involving excessive demand on health and social services.
The CBA’s National Immigration Law Section has offered its thoughts on the matter in a submission which focuses on the three main issues identified in the report: resolving limitations on operationalizing excessive demand policy; reducing the number of overturned excessive demand cases; and enforcing mitigation plans.
“A medical inadmissibility finding has a serious consequence, barring entry to Canada for foreign nationals, ranging from family class applicants to temporary workers and economic migrants,” the submission says. “It can hinder family reunification and have significant consequences for Canadian businesses. However, a decision made in error could also lead to the admission of individuals whose medical conditions result in excessive demands on Canadian health and social services.”
Overall, the Section says it supports efforts to streamline the process, and it believes the Health Screening and Notification Program “could be improved without significant overhaul of the program, or legislative and regulatory amendments at this time.”
The submission makes a total of 16 recommendations. From the operational standpoint, they touch on everything from defining the distinct roles played by the Medical Officers and Immigration Officers, to using plain language in the Procedural Fairness Letters sent to applicants and providing clear instructions to them, to portraying immigration lawyers favorably on the IRCC websites.
Reducing the number of overturned cases involves going back to those cases to see why the earlier ruling was changed – was the ruling of medical inadmissibility inappropriate, or was it overturned for humanitarian reasons? If it is the former, the Section recommends focused and coordinated training between IRCC and the Canadian Border Services Agency to explain case law interpreting excessive demand and emphasize the respective decision-making powers held by Medical Officers and Immigration Officers.
“A major concern highlighted in the IRCC Report, limiting the application and intended results of the excessive demand policy, is the inability to monitor and enforce mitigation plans” prepared by applicants to show that they would not be a burden on the health or social services systems. “However, no evidence to support this concern was in the IRCC Report. The Report also noted that a large proportion of clients comply with the medical surveillance requirement, albeit not in the excessive demand regime.”
The CBA Section makes a number of recommendations for this issue, including a pilot program implementing new tracking measures, and using new monitoring and enforcement mechanisms – and also the more effective use of existing mechanisms.