Good evening, ladies and gentlemen. Welcome to the 84th meeting of the Standing Committee on Citizenship and Immigration, which I'm happy to call to order today. We are beginning a new study tonight. We're studying the federal government policies and guidelines regarding medical inadmissibility of immigrants.
It's a new study, and the committee is gathering information from witnesses as we begin this process. I'm very pleased that we have such a good variety of witnesses tonight coming to help us with this really interesting topic. From the Council of Canadians with Disabilities, we have John Rae and James Hicks. From the Canadian Institute for Health Information, we have Brent Diverty and Chris Kuchciak. We also have Lorne Waldman.
Welcome, Mr. Waldman, via video conference. We're going to begin with Mr. Waldman as our first witness just because, with the technical aspects, things sometimes go wrong. If we begin with you, then we know we have your testimony for sure, but we'd like you to stay around for questions as well.
We'll begin with an opening statement from Mr. Waldman.
There are two grounds of inadmissibility under the Immigration and Refugee Protection Act. One is danger to the public, which really doesn't arise very often. I see cases of people who have tuberculosis. If it's active, they have to get treated before they come to Canada. If it's not active, then they are put under surveillance and they have to follow treatment once they arrive. It's very infrequent that people are refused on the grounds of danger to the public.
The more common ground is excessive demand on social and/or medical services. It's interesting to note that the law was changed some years ago, because excessive demand used to apply in all cases involving all applicants for permanent residence, but the Parliament of Canada decided to exempt spouses, dependent children, and protected persons from the excessive demand criteria, a reflection of the fact that the government thought that it was important that those people be allowed to come in and be reunited with their families. Excessive demand now is a ground applied mostly in the case of parents and grandparents, and also in the case of independent or economic migrants who seek to come to Canada.
Several issues have arisen in relation to this process. The first was exposed recently by a reporter for one of the news networks, who discovered that the calculation of average and excessive demand—excessive demand means you cost more than the average amount of money that a regular Canadian would cost—were based on fictitious information. There was no actual true calculation of the cost for the average person, so one issue that needs to be carefully studied by the committee is how authorities come to the number they apply in all of the cases. The reporter discovered that there was absolutely no factual basis for it.
There are other important issues that need to be considered when one considers excessive demand, and those deal with the hardship that often results from the indiscriminate application of these criteria. For example, one of the most common types of cases I see in my office involves people who are trying to bring their parents into the country, and they have medical issues, and they're unable to bring them. This creates huge problems. It creates emotional issues, because people feel that as their parents get older, they have to care for them. The application of the excessive demand criteria, in this context, creates a huge amount of emotional hardship.
The second thing we need to consider when we consider the excessive demand criteria is the fact that they are also applied in the case of economic immigrants. One of the things we need to consider is that, as the demographics of the world change, Canada is a country that needs immigrants in order to meet our demographic needs over the next 40 or 50 years, and we are competing with other countries that find themselves in the same situation. Canada needs to understand that putting up barriers that make it more difficult for the more attractive immigrants to come to the country may have a negative impact on our ability to attract the most qualified immigrants.
From the point of view of an excessive demand analysis, one also has to engage in a cost-benefit analysis. This requires us to consider the emotional hardship that occurs when people are separated from their families, and also requires us to consider the impact of a strict application of the excessive demand criteria on our ability to attract the most desirable immigrants as we move forward.
I think that when you consider the medical inadmissibility over the next weeks, you need to consider these issues, and consider whether or not, in fact, we need to reconsider the inflexible approach we've seen applied by the officials to excessive demand over the course of the last many years, and either get rid of the whole notion of medical inadmissibility—because from a cost-benefit point of view, it doesn't make any sense—or at least guarantee that there's a much more flexible approach that will take into account the hardship that arises as a result of an inflexible approach; and also the fact that we may be harming ourselves by making it more difficult to attract the types of immigrants that we will need in the years ahead.
Yes. Thank you, Mr. Chair and honoured members of the committee.
We are really pleased to be here tonight, and are delighted that you are taking up this important issue. We are here to recommend in the strongest possible terms that the excessive demand clause in the immigration act be repealed, and having made that comment, I'm tempted to rest my case right there, but of course I'm not going to.
Let's look at it from a number of perspectives, first of all, philosophical. The existing provision, in our minds, is mired in outdated ableist, offensive, and stereotypical notions about disability, in which it seems that we are considered automatically to be a burden upon society. Needless to say, as an organization of persons with disabilities, we reject, out of hand, that notion. However, the continuation of that phrase in the act is demeaning, and if you think about it from where we sit, basically that phrase is saying that we aren't wanted in Canada. That's not the Canada that I understand that I live in, nor the Canada that I want, nor do I believe it is the Canada that you and your fellow members want either. So, this provision must go.
When the Canadian Human Rights Act was proclaimed, we hoped that would signal a new era; it did not. When the Charter of Rights came into force, again we were hopeful but again disappointed. When Canada signed and later ratified the UN Convention on the Rights of Persons with Disabilities, again we were hopeful, because prior to ratifying it, the Government of Canada consulted its provincial counterparts. But again, we've seen no movement.
Today we are on the verge of a promised national accessibility act. We suggest to you that this repeal is long overdue and very timely, and can be done either through legislation proposed by you or as part of the national act. In order to make the kinds of tangible differences in our lives that we want, and that you folks have led us to expect, that bill needs to include the amendment of a number of pieces of legislation.
In practice we have an immigration system that runs several different ways. If you're a refugee, the excessive demand clause doesn't apply. If you are rich and have lots of resources, you can argue that you can cover whatever excessive demand costs may exist. If you are neither, you are often forced to almost beg the minister, on compassionate grounds, to let you stay in Canada. It seems that in that case, the squeaky wheel gets the minister's permit. If a person raises enough trouble and threatens to go to court a lot of times, the permit is issued.
We don't think Canada should have a “several streams” kind of process. We do support the need for refugees to be fast-tracked. We understand where they're coming from.
With regard to the numbers game, we suspect some people are concerned that if we repeal this offensive section, Canada will be flooded with applicants for landed status. We see no evidence to support that idea, so we consider this an outdated provision whose time to end has come.
I want to leave you with one final thought. Consider this list of Canadians; it's not exhaustive. You will know many of these names.
There's the and the . Catherine Frazee is the former chairperson of the Ontario Human Rights Commission. Yvonne Peters, I think, is the current chair of the Manitoba Human Rights Commission, and Jim Derksen was formerly with Disabled Peoples' International. Sandra Carpenter is the leading spokesperson in the independent living movement in Canada and around the world.
That's not an exhaustive list by any means, members.
Consider this though. We in Canada have benefited from their work and their expertise partly because through good luck they were born in Canada. What would have been the result had they not been? One thing that is common with those individuals and others such as Rick Hansen is that they all have an ongoing permanent disability. If they had lived outside of Canada and had applied to immigrate to Canada, how would their applications have been viewed and dealt with by immigration officials? How would they have been?
I ask you to ponder that question tonight and as you go forward, and I submit that Canada would not have been able to benefit from at least some if not all of the work of those important and significant Canadians, because a lot of them would have been denied the opportunity to come to Canada.
That's not the kind of Canada I want. We need to be able to benefit from the interest, the aspirations, and the contributions of everyone, and we reject any notion that disabled people are automatically a burden. The work and contributions of those individuals put the big lie to any such contention. I invite you to ponder that point if not others.
Thank you for the opportunity to be here.
Good evening, Mr. Chair and committee members. On behalf of the Canadian Institute for Health Information, I'd like to thank you for the opportunity to appear before the Standing Committee on Citizenship and Immigration.
Since 1994, CIHI, the Canadian Institute for Health Information, has been an important organization in Canada's health sector. We are a not-for-profit independent body funded by the federal government and all provinces and territories. Our board of directors is made up of deputy ministers of health and other health system leaders representing all regions of the country and the federal government.
When we were created over two decades ago, we had three databases. Today we have 28, and we have data-sharing agreements with every province and territory, Health Canada, Statistics Canada, and the Public Health Agency. CIHI is a leader in health data, methodologies, and system performance measurement, and we are recognized internationally for our work. Over 20 years we have become the authoritative source on a range of health system topics, including health expenditures.
Our role in the health system is to make data publicly available for people like you, Canada's policy-makers, as well as for the health system, researchers, and the general public. We are neutral and objective in fulfilling our mandate to deliver comparable and actionable information. Our aim is to give people the tools they need to drive improvements in health care, health system performance, and population health. Ultimately we work to improve the health care system and the health of Canadians across the country.
Earlier this month we released our annual report on health spending in Canada. “National Health Expenditure Trends” examines how much is spent on health care each year, where the money comes from, and how the money is spent. For the past 20 years, we've been responsible for reporting on health spending in Canada, continuing work that began 40 years ago with the purpose of supporting the development and evaluation of health programs in Canada.
Our report is based on a classification system that is consistent with international standards developed by the OECD for reporting health expenditures, so the focus of our work is on health system expenditures. Spending in important areas such as social services, including income support for housing, home supports, and home support services, is not included, even though these areas may impact health. Total health spending in Canada includes both public and private sector expenditures. These are further broken down into broad categories such as hospitals, drugs, physicians, and other institutions such as long-term care, nursing homes, and professional services for things like dental and vision care, and so on. We call it NHEX. This report combines readily available information from public accounts, annual reports, main estimates, Statistics Canada, and private health insurance. This information is used to produce estimates for the current year.
Current year estimates are revised to actual expenditures once they are confirmed, typically with a one- to two-year lag. It's just one example of how publicly available data is used by government officials, provinces, and territories, and other third party organizations, all with the common goal of improving the health of Canadians.
Canada's health spending is forecast to grow almost 4% this year to $242 billion. This is a slight increase in the rate of health spending growth. We've seen an average growth rate of about 3% since 2010. Health spending is forecast to be $6,604 per Canadian. This is almost $200 more than last year.
Total health expenditure per person is expected to vary across the country from $7,378 in Newfoundland and Labrador and $7,329 in Alberta to $6,367 in Ontario and $6,321 in British Columbia. This variation across the country occurs for many reasons, including differences in population demographics and health status, prescribing practices, public program design, and other factors.
The results of this report are also used to compare Canada with other OECD countries. In 2015, which is the latest year for which we have actual expenditure data, Canada's per-person spending was among the highest internationally at $5,782 CAD, which is a figure comparable to those for the Netherlands, France, and Australia, but much lower than that of the U.S. at $11,916.
Hospitals, drugs, and physician services are the categories that continue to use the largest share of health dollars. Over time, the share allocated to hospitals has been decreasing and the share allocated to drug spending has increased. In 2017 spending on drugs is expected to grow at an estimated 5%, spending on hospitals at about 3%, and spending on physicians at about 4%.
We've identified several major cost drivers, including inflation, population growth, and the aging population. Population growth and aging account for 2% of total health spending growth per year. Over the last several years, we have found that population aging, in particular, is a modest but steady cost driver, about 1% per year.
In closing, I'd also note that we have a new strategic plan for the years 2016-21, identifying strategic goals that build on our core strengths as an organization and that focus on priority populations, including seniors, children and youth, indigenous people, and those living with mental illness and addictions. Along with our stakeholders, including the federal government and the provinces and territories, we identified these priority populations.
I thank you for the opportunity to present this information. My colleague Chris Kuchciak and I would be pleased to answer any questions you may have.
That used to be the way it was done. For example, Manitoba had a scheme whereby you could pay an amount of money as a bond for future expenditures. That was cancelled.
There are ways one could move forward and look for compromises such as people offering to pay bonds or provinces agreeing to allow people to come into Canada.
Obviously immigration is a shared responsibility, so any decisions you make you are going to have to discuss with the provinces as well, especially given that the medical expenditures are provincial.
I think when you look overall at the number of people we're talking about, 900, even when some of them have significant costs as a factor of the total amount of money you're spending, it's insignificant in terms of health care dollars, and it creates a whole series of impediments both to family reunification and to having the best and most skilled people come into Canada.
When we look at all of these things, I wonder whether it makes sense to continue with this program.
Thank you very much, Mr. Chair.
Thank you to all the witnesses for their comments.
I certainly appreciate and agree with the suggestion that we should get rid of this criterion altogether. If you look at it, you see that it is an issue around picking and choosing, and saying to the world that people who have different abilities are not welcome in Canada, because at the end of the day, that's what we are talking about.
Just to build on this notion, the idea of fixing the issue somehow, somewhat with a patchwork approach.... Mr. Rae, you've expressed very clearly that this would not work. Mr. Waldman, I think we've heard from you as well that, given the context of the small number of people who would fit into that category, it is perhaps not the right approach to take.
I want to touch on this issue, too. We had officials who came forward and advised this committee that in fact they don't evaluate the contributions of individuals and their family units. You could be a family unit with somebody deemed to have “excessive demand” or even an individual with a different ability. They don't evaluate the contributions of those individuals; they look strictly at the cost side.
Mr. Waldman, can you comment on the problem with that kind of evaluation? Not to mention that, as you said in your opening statement, it has been found through various media reports that IRCC's approach to assessing the cost is fraught with problems....
I think probably it's too late to really deal with past cases. They've been refused based upon data we think is inaccurate. We see it in two ways. First of all, the government has to estimate what they think the likely cost will be for the individual who's applying to come to Canada. That's based upon arbitrary assessments of services the government believes they might need.
I'll give you an example. We have people who have some kind of a mental handicap and the government says they're going to need special education, and they factor that into the cost. Special education is quite expensive for sure, but what we see, for example, is that people who come at a certain age don't speak English, and are not likely to be able to speak English, and the special education programs aren't offered in the language in which they speak, yet they're being costed as if these programs exist, when in fact they don't really exist.
That's the kind of arbitrariness we see in the system as it now develops. When you couple that with the fact that the number the government has been using for the average cost.... Because remember the average cost isn't the average cost of a Canadian, it's an average cost of a person of the same age group, so as you get older the cost goes up and the average goes up, but the government's estimates have been off.
When you put those two things together, there are a lot of people who are being rejected unfairly. If they've been rejected unfairly in the past, there's not much we can do about that, but we have to make sure that if this program continues—and I hope it doesn't but if it does—it's based on fair and accurate data.
I look at 900 seniors, then, as an $18-million cost, and you just indicated, Mr. Waldman, that if we tripled this, it would be somewhere in excess of $12 million more. I did the numbers, and according to the CIHI number here of $5,782 for an average person's spending in Canada on health care, it's $5.2 million. If you triple it, it's $15.6 million.
I look at your situation, and whether or not it's exactly 900 people who would be impacted by this, or 1,900. Do either of you, Mr. Waldman or Mr. Rae, have any idea what those costs were in regard to administration, or would you have those numbers, Mr. Diverty, from CIHI, for the costs of the admissibility, for doing the paperwork and that sort of thing, for each individual? As you've given us for health care costs, is there an average for paperwork, just for health care in Canada as well, that would apply here?
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.
As Michael said, our firm really does specialize in representing people who deal with medical admissibility issues, so I want to focus on two examples from our practice where we've seen these real problems with procedural fairness letters.
One problem is the fact that this excessive demand threshold, which is currently set at $6,655 a year, is not accurate. We saw that the Global News investigation from July 2017 found that IRCC isn't even considering the social service costs. They're costing it at $356 per Canadian per year. That number doesn't include special education services, which we know are required by one-third of the people that we're talking about under medical inadmissibility. I think there's a real problem with the number. As Michael said, the resources that the IRCC would have to pour into making this number accurate are going to be significant, so we're coming to the situation now of “is this a system that's even worth saving?”
This number of $6,655 per year is really important. It means everything to the client. If you're one dollar over this number, it makes you inadmissible to Canada.
We had a case recently in our office where the IRCC said the cost of our client's HIV medication was $400 over the excessive demand threshold. Our client had an advanced degree. He had years of management experience at an international accounting firm, and there was no opportunity to take into account the fact that he would contribute significantly to the Canadian tax base. The interesting thing is that his desirability as an immigrant to Canada was really reduced to this $400 over the $6,655 per year.
The second example that I want to give from our practice deals with the discriminatory nature of this section of the law. The IRCC has repeatedly stated that medical inadmissibility is tied to the cost of services, not to the health condition, but if every single child with a disability is getting one of these procedural fairness letters, then in fact it is de facto discriminatory.
We're questioning the implementation of this law. We're urging the committee to repeal it. You'll hear from other witnesses, and we've heard from the panel before us, that this is a system that discriminates against persons with disabilities.
In 2015 we represented the mother of a 14-year-old teenager named Jazmine. She was found inadmissible because she was deaf. Her case was heavily publicized in the media. The procedural fairness letter that Jazmine's mother received essentially said that her daughter would be a burden on Canada. I think the sad part about this is that Jazmine's disability really is just one part of her identity, but IRCC saw this as the only relevant part of her identity.
I think it is discriminatory to see persons with disabilities as a burden. If you speak to any parent who has a child with a disability, you can see the positive change and impact they have on their families and their communities. Jazmine's mother worked for seven years in Canada. She paid taxes every single year. I met Jazmine last year in Vancouver, and she's thriving in her school. She has so many friends. It's one of those situations where she really isn't a burden on the social system; she's attending a public school in B.C. Jazmine and her mother should never have been subjected to this discriminatory process.
Good evening, committee. I'm a Jamaican lawyer working with the Canadian HIV/AIDS Legal Network where I collaborate with local groups to challenge HIV in the Caribbean.
As a Caribbean immigrant to Canada, I'm aware of our shared history of discriminatory colonial-era laws. Canada has excluded immigrants with disabilities, since before Confederation, when it denied immigration to persons considered physically and mentally defective.
While the Immigration and Refugee Protection Act no longer employs such reprehensible language, the excessive demand regime is rooted in discrimination and conceals outdated prejudices that people with disabilities are a burden on Canadian society. Ironically, the U.K., which was the source of these discriminatory laws, got rid of them, while we cling to a regime that fails to serve its stated purpose.
In 2010, Canada celebrated our ratification of the UN Convention on the Rights of Persons with Disabilities, and the federal government has expressed its commitment to upholding and safeguarding the rights of persons with disabilities and enabling their full participation in society.
Article 18 of the convention specifically calls on states parties to “recognize the rights of persons with disabilities to liberty and movement, to freedom to choose their residence, and to a nationality”. The excessive demand regime clearly violates this convention.
The UN has also repeatedly called upon countries to eliminate HIV-related restrictions on residents and described HIV-related discrimination in immigration as a violation of the right to equality before the law. By effectively preventing people who are living with HIV from becoming legal residents, the excessive demand regime also violates the rights of people living with HIV and other disabilities to education, employment, and health, as provided for in numerous international human rights laws that Canada has ratified.
Several countries do not have any laws or policies that deny immigration based on HIV status. For example, the U.K. does not impose mandatory HIV testing for those entering the country as immigrants. Driven by increasing public pressure to reduce the number of migrants to the U.K., on the grounds that they were overburdening the social welfare infrastructure, nevertheless, the U.K.'s All-Party Parliamentary Group on HIV and AIDS concluded that the U.K. government cannot look to exclude individuals on the basis of poor health in the U.K., while simultaneously working to provide access to health in developing countries.
The same can be said of Canada, which has invested roughly $350 million between 2001 and 2011 on international projects with a focus on disability and recently pledged over $800 million to the Global Fund to fight HIV, TB, and malaria, yet the excessive demand regime would deny some of the very persons who we fund overseas from coming to Canada.
On a personal note, my brother and I now live in Canada, while my ill parents are left alone in Jamaica. Neither would qualify as Canadian permanent residents because of excessive demand. When one parent eventually dies, we will have the hard choice of what to do about the other. Our parents have been a great source of support to us. Now, Canada's discriminatory immigration regime excludes them and many others like them from the care they need simply because they are deemed undesirable.
This is a legacy that we should not continue to defend.
My name is Meagan Johnston. I'm a staff immigration lawyer at HALCO, the HIV & AIDS Legal Clinic Ontario. We serve people who are living with HIV in the province of Ontario.
At HALCO I witness my clients' pain and frustration caused by the discriminatory excessive demand regime on a daily basis. Even for people who are ultimately accepted after all the paperwork, dealing with excessive demand is a terrible way for someone to start their new life in Canada, and the sense of exclusion that it creates stays with my clients for years afterwards. I want to illustrate this with some examples from my practice.
First, I routinely advise international students who have contracted HIV here in Canada during their studies. These students had planned to pursue their studies, gain work experience, and then apply for permanent residence. Their futures are now turned upside down because their application to stay in Canada can now be refused because of excessive demand. This threat of refusal is particularly ironic since international students represent a group of immigrants that Canada states it most wants to attract.
Second, at HALCO we often represent clients in their humanitarian and compassionate applications, H and Cs. Our clients' H and C applications take years longer to process than those of other applicants because they have to request waivers for medical inadmissibility due to their HIV before they are granted approval in principle. During this time, my clients remain in limbo, unsure of whether their application will be approved and they will get to stay in Canada. It's harder to successfully integrate when you spend years here not knowing if you'll be able to stay. One client's child aged out of the definition of dependant while her H and C application was being processed. This meant the child could no longer be sponsored after my client got her permanent residency.
Third, the excessive demand regime creates a climate of fear for people living with HIV. New clients regularly ask me on the phone or in person if their HIV status will be a problem for immigration, or even for citizenship, where it's completely irrelevant. Even people who are exempt from excessive demand still get the message that someone's HIV status can be, as so many of my clients put it, “a problem” for Canada.
The discrimination inherent to the excessive demand regime isn't just in the refusals. It's in the way the excessive demand regime forces people living with HIV and people with other disabilities into a different process with more hoops and longer wait times because of their disability. That is discriminatory.
Excessive demand is still discriminatory even if it focuses on the cost of health or social services and not the medical condition itself. This is a false distinction. It doesn't make a difference to my clients to know they're not begin refused because of their HIV status but because of the cost of their life-saving HIV medications. They're still being refused.
The department justifies excessive demand on the grounds of cost savings, but there are many costs associated with immigration, such as settlement services, language classes, and the costs of educating newcomer children. These costs, however, are not considered in the immigration application process. By only considering the costs of health and social services, and by using these costs as grounds for exclusion, the excessive demand regime relies on outdated and discriminatory stereotypes that people with disabilities are a burden, and it erases the important contributions that people living with HIV and other disabilities make to Canadian society every day.
We urge this committee to show leadership and recommend removing excessive demand inadmissibility by repealing paragraph 38(1)(c) of the IRPA.
Good evening. Thank you for inviting me to share my story.
My name is Mercedes Benitez, and I am a mother and a caregiver. I came to Canada in March 2008 under the live-in caregiver program. My husband, Romeo, and sons, Harold and Bill, are in the Philippines. When I first came to Canada, Harold was nine and Bill was 14 years old. I applied for permanent residence in 2010, after working for two years. In my application, I included my son and my husband. While I was working in Canada, I missed Bill's high school graduation because my husband and I agreed that I should focus on completing the requirements of the live-in caregiver program. Even though it was very hard for me not to be there to celebrate my son's graduation and to miss my boys' birthdays and all our Christmases together, we could bear it because we knew that eventually we would be reunited. You cannot imagine the pain of a mother knowing that her sons are growing up without her.
In November 2015, after waiting five years, I received a letter from immigration saying that we might be refused because of Harold's intellectual disability. I was devastated. It hurts me to feel that Canada thought we were not good enough. The months of uncertainty since we received the letter have been some of the hardest months of my life. I had chest pains; at times I thought I was having a heart attack from the stress. There were so many sleepless nights worrying that any day I could be refused and sent back home after working so hard for so many years. I was afraid. Who would provide for my family? Sometimes it was too much to bear and I thought of giving up, but my family relies on me for support. I am the sole breadwinner. I needed to be strong.
In Canada, it is said that everyone has equal rights, but the decision to find me and my family inadmissible based on my son's disability made me question this. I was eventually able to get legal assistance, and just two weeks ago I was told we would be approved for permanent residence on humanitarian and compassionate grounds. I couldn't believe it. I feel as if I won the lottery. I am so grateful, but I wonder about others who are also in the same situation that I was. I'm not sure how many of you are parents, but put yourself in the shoes of a mother who is being told that she cannot stay in Canada because her child has a disability. Excessive demand should be eliminated because there should not be any more mothers crying every night or children discriminated against based on their disability or health condition. We need change now.
Thank you for listening.
My name is Toni Schweitzer. I'm one of the lawyers at the Parkdale legal clinic in Toronto, and we were able to work with Mercedes. She came to us almost on the cusp of her and her family being ultimately refused. We were able to work with her and, as you have heard, her case was ultimately successful but on a discretionary basis, on humanitarian grounds.
What I think you have just heard is a first-hand account of what this section does to people. This was a family who, for at least five years, was living with the threat hanging over their heads that they were going to be refused because one of their family members was non-desirable.
You've heard lots of lawyers and bureaucrats talk, and now you've heard what this actually does to people, the amount of mental and psychological stress it causes people who are here or who are applying, who are going to contribute. That's exactly what Mercedes did. She has worked for many years as a caregiver to an elderly man in Toronto. As we are an aging population, we all know there's an increasing need for people who are going to do this kind of work. That's exactly what Mercedes was doing, yet at the end of that, we as a country were prepared to say she wasn't good enough: “Thanks, now it's time to go.”
Her case didn't turn out that way, but that's not an answer to the unfairness of the law. It is simply not acceptable to say that we can fix a law that is arbitrary and unfair by saying there can be discretionary decisions made in the appropriate case. Then you're in a position where you're saying that only those people who have the ability to mount a case, to build publicity, to get the media involved, are the ones who are going to benefit. That's simply arbitrary and unfair, and I don't think any of you would agree that this is a country where we should say that is okay.
I want to make two other points.
Basically, I want to supplement what others have said, and I want to take issue with a couple of things that you have already been told by other people who have appeared before you. You, as some members of this committee, had asked other officials who have appeared before you whether this law has ever been found to be unconstitutional. Previous witnesses have left you with the impression that this law has been carefully considered and found to be constitutionally sound. I think it's important that you understand that's not entirely true.
There are in fact two cases where this issue has come up, one in which the court didn't really address it. It was a case of the Federal Court of Appeal in 2002. The way in which the case came before the court didn't allow them to look at the issue from the point of view of the applicant who was being discriminated against. It was in the context of a sponsorship appeal, and therefore, it was the sponsor in Canada. The court said it was hard to see where the discrimination was against the sponsor. That case certainly does not stand for the principle that this law is constitutionally sound, or that the Federal Court of Appeal so found it.
The other case in which this law was looked at was the Chesters decision, which I don't know if any of you are familiar with. It was a challenge to the excessive demand provision as it stood under the old act. It was brought in relation to a woman who was the spouse of a Canadian citizen, who at that time was subject to the excessive demand provision. The court ultimately found that it was not an issue of discrimination because it wasn't based on disability; it was based on cost.
I think you have now heard from enough people that, while the language of the provision is in terms of cost, the way in which it is applied and interpreted is solely on the basis of a person's disability.
As you can imagine, my organization has been working on this issue for quite some time, we're very keen to see any cost savings estimates that the department can provide. We were very interested by this figure that was mentioned, which was the $135 million over five years, which, I guess, people narrowed down to about $27 million a year.
However, if you look through the transcript, it would appear that the cost savings estimates are coming from the procedural fairness letters themselves. How is the department estimating its cost savings? It is taking the cost estimate that's given to an applicant in that procedural fairness letter, and it is using that to estimate how much cost is actually saved.
The issue, of course, is that my colleagues here have spoken to the inaccuracies in the procedural fairness letters. For example, for clients who are living with HIV, they may have switched to a generic HIV medication, which is much cheaper than the medication that's set out in the procedural fairness letter, but also, for example, with my H and C clients, we request, and often receive, waivers of medical inadmissibility.
These cost estimates, from what we can tell from the transcripts, do not factor in any revisions to the cost estimates that applicants may submit or any cases where a waiver is granted. Our concern, based on the information that the department has provided to these proceedings, is that there is a significant overestimation of the actual cost savings.
Lastly, those cost savings do not take into account the cost of actually administering the excessive demand program. As my colleague, Mr. Battista pointed out, and as Mr. Waldman pointed out in the previous panel, there is an incredible amount of cost that goes into administering this program. From what we're seeing from this transcript, those costs are not taken into account either.
Ms. Benitez, I am very glad for the outcome of your situation. The situation I was talking about earlier, in the previous panel, was one in the same area. Not everybody is fortunate enough to be picked or chosen, or whatever, on compassionate and humanitarian grounds. That is why I raised the humanitarian issue in the previous panel.
While I appreciate the fact that it's there, it's where I was going when I asked whether a province could have some say in the finality of this. Never mind the province wanting to pay for this—I have a community that would have paid for the extra costs of having that individual live in the community. The parents would have been making far more—just in the taxes they would have paid—than what the costs would have been. There would have been a net benefit to the community, but it can't be a net benefit if they are all rejected as a family, and of course they weren't going to stay if the youngest person in the family was rejected.
Do you have any comments on that, Ms. Schweitzer?
Thank you very much, Mr. Chair.
Thank you to all our witnesses.
First I want to say, congratulations to you, Mercedes. Your story.... You had the courage to speak up and bring this to the public realm; that's why we are here today. You won your case less than two weeks ago, and you still show up to make the pitch and say why this law needs to change. I can't tell you how much that demonstrates the value that you, and people like you, add to our society and to our country. That is what we are talking about. I don't know how to measure that—not in dollars, not in cents—but I'll tell you that it is worth its weight in gold in terms of what you stand for and the humanity that Mr. Rae talked about earlier, about who we are as Canadians. Thank you for that.
I want to talk about the international law issue, and the fact that Canada.... We say we're back, and it's so good to say we're back. Let's measure, on this policy, how we're back. Canada has made commitments to equality and human rights of people with disabilities in our Canadian Charter of Rights, and we have done so provincially and federally with our human rights legislation. We are also a signatory to the UN Convention on the Rights of Persons with Disabilities, yet we have this law, the Immigration and Refugee Protection Act, which states that an individual would be discriminated against based on their different abilities. To that end, for us to say we're back on this score, what does the government need to do?
I'm going to go down the line to everybody. Perhaps you could get your comments on the record for us by way of recommendations—in a short answer, because we have limited time.
We'll start with Mr. Tomlinson.
We're going to call the meeting back to order.
Just before we get into the business portion of the meeting, I'll note that there was a request from Ms. Kwan for a copy of a 2004 baseline study upon which the rates were set and then increased through inflation and experience over the time. I think it would be very good for our committee to have it before the minister is here; however, it is available in English only, and it is about 50 pages.
I'm going to seek unanimous consent to have it before the committee, knowing that we would have French translation immediately following as soon as it's available—just to have that available for people to understand. I am going to seek unanimous consent on that.
Some hon. members: Agreed.
The Chair: We recognize this as an exception and that all the documents will be bilingual, and it will come hopefully as quickly as possible. We're doing a compressed study, so I think it is an exception.
||That, notwithstanding the motion adopted by the Committee on October 16, 2017, the Committee hold an additional meeting prior to December 20, 2017, on the resettlement issues related to Yazidi women and girls; and that the Committee report its finding to the House; and that the government table a response.
For the committee's benefit, I'll give a little bit of a background on my week last week during our constituency break. I had the opportunity to meet and have calls with several of the community groups that are providing resettlement services for the Yazidi community across the country, and they watched what happened at committee last week.
To my colleagues opposite, the Liberal government has a majority government right now, which means they have a majority on this committee. This means that the Liberals, should we adopt a report, have the ability to basically word the report as they see fit. Opposition members can put a dissenting report on the end, but the thing with a report is that the government is required to respond. I don't understand why the committee members would do anything other than have a report attached to the findings of this committee, outside of the fact that they have been directed by the centre that it doesn't want the government to respond to this.
Here is what happened last week. I sat in the living room of a Yazidi family's home and I had to listen to stories about how they have family members in other parts of the country who have been redirected. They're isolated. They're struggling. We don't have enough translation services for people. It was never the intent of this committee—and I certainly hope it was not the intent of the government—to bring these people here who have suffered so much just to leave them to their own devices when frankly their lives are still at risk.
Frankly, I want to take issue with something that was said at the last meeting, that moving this motion was Conservative—I can't remember the word that was used—histrionics or hyperbole or theatrics. Yes, I get worked up on this issue, but every Canadian should get worked up on this issue. The member who said that.... I would like to ask for an apology on it. I do not understand why every single time this issue comes up before this committee we can't just do something that resembles work.
My understanding is that somebody from across the table is going to move a motion that this is going to be a letter to the minister, which the Liberal members will do anyway. It removes the responsibility of the government to respond to the work of this committee. If the government members want to respond to the centre, if they want to take direction from the centre rather than from people who are sitting at the end of the table, that is fine. That's your prerogative. You can write the recommendations in that report how you see fit. I want the government to have to respond, because if we don't get this right, we are failing the world's most vulnerable.
I am so sick of sitting in the living rooms of these people's homes, of listening to these women, and of us failing to act on their behalf. I don't want to have to come to our chair and to each and every one of you every three months asking for another report on this because we are not making ends meet. I don't want to have to keep asking our chair in the House of Commons what we're doing. I don't want to have to keep listening to department officials saying that only five women have had access to care. I just want it done, and I don't understand why this is so hard for this government that makes their brand “welcome to Canada”, doing something that's compassionate. If somebody across the way is going to entertain amending this motion, I don't accept it. I'm just going to pre-empt you right now.
We need to have a report out of this study. We need to have some concrete recommendations on how the government is going to go forward. The Liberals in this committee can do as they see fit. Every single person I met with and called this week does not understand why there is a disconnect between the message that the Liberals put forward with the Syrian refugee initiative and what is happening with this particular cohort of people. I don't understand it, either.
I ask each and every one of you from the bottom of my heart, from a place of genuine concern for women whose lives are at risk, to just issue a report. Your minister can put forward whatever he responds, but you cannot have good government unless you have good opposition. I am so tired of keeping my staff involved in this. I'm so tired of spending so much time on something your government is supposed to be good at.
I look at you as members who are not part of the government. Your job is to hold the government to account too, even if it's the same party.
If you're going to amend this motion, no, I don't accept it. If you want to put forward a letter to the minister, that's cowardice. If we are going to do this, we should do it right. There is absolutely no reason outside of cowardice and bowing to the centre, abandoning these women, that we would not put the findings of this committee study into a report.
I rest my case.
Thank you very much, Mr. Chair.
I would not support the amendment. I think that the reason is quite obvious, really, and that is for us to do our work. We had compelling information that came forward from the officials and from the witnesses who came before us. To write a letter...some people would say, “What is the difference between a letter versus a report?” Well, there's a significant difference.
A letter is simply to say, “Here's what we heard.” A report will speak to recommendations and the government would have to respond to those recommendations as per the rules as they apply to committee. I think that there is value in that. I think there's value in that for the opposition, but also for the government members too. More importantly, I think there's a lot of value in that for the people who came before us.
I can't get out of my mind the victims, the survivors, and particularly Nadia, who spoke with us in her first meeting in the summer. It seems so long ago now, but it really wasn't that long ago. I remember meeting her at my office and how looking at her I could see how her trauma was haunting her still. In spite of that, she found the courage to come before us, to advocate, to do this work, and to continue to do this work. The work is not done. The job is not done. We've only just begun this work. In that process when we heard from the witnesses in the summer, I had always envisioned that the first phase of this work was to do this immediate 1,000-plus people in terms of coming forward, and that there were steps to follow. We all heard that at the committee.
I will finish by simply saying that it was always my hope—and I thought it was the committee's vision as well—that we would do this work in the summer as phase one, which the government did act on and which was to bring the 1,200 Yazidis over by the end of the year, but we always knew that work was not complete. We always knew. At least in my heart, I knew that work was not complete and that we needed to continue. The witnesses who came before us in the summer said that as well. That's exactly what the witnesses in this round said to us in terms of the work that needs to continue. I really don't understand why there is harm for this committee in doing our work independently.
Mr. Chair, you are a new chair of this committee and you have said to me—and I don't think you mind me saying this publicly—that this committee works independently of government and independently of the minister, and that we have our own minds and our own capacity to do our work. The chair before you, Mr. Oliphant, reiterated the same thing. He said to us that the work we do here could be some of the most important work that we will do as members of Parliament. We have the chance to make a difference in putting forward this report.
We're talking about saving lives: the lives of people, of women, of victims who have been raped. There are victims who are being killed, and there are those who are coming out to plead for help. There is a genocide against this community. We owe them that much, to say that this work will continue. We owe them that much to do our work as committee members to put a full report to the and to have the minister respond to us accordingly. That is accountability. That's transparency. If we do that, we should all be very proud of what we're doing here, even when we disagree, Mr. Chair.
I hope the members will retract the amendment. Let's get on with it. Let's get on with it and do something that's really cool, you know. I think we can do it.
If we are not going to issue a report on this, I do not understand why the should not have to come in front of committee to answer to this.
The other thing is that I've had experience in drafting letters in this committee before. It has not been a pleasant experience. If the Liberals, using their majority, are going to draft a sunshine-and-roses letter to the that he's not required to respond to, I would like that to be done in public so that the witnesses we've had before this committee can see the deliberations. I would like the minister to come and respond to this.
I am furious. I don't understand why we can't act on this. I do not understand why we are not requiring the government to respond to this—honestly. There are real challenges. We're doing something new. The government, to their credit, they're doing something new, but the reality is that this group of people has different needs than other groups of refugees who we have brought in, and we are not capable right now of meeting their needs.
That is the role of this committee. We have had recommendations. The government might not agree with it. The government side might not agree with it. That is fine, but we need to do our work as parliamentarians and say that the system we have, the siloed system of a standardized support for GARs, is not meeting the needs of this group of people, and their lives are at risk. I do not want to have to come back here because one of these women has taken her life, and that is what we're talking about here. I don't want to have to do that.
I do not understand why we can't have a report. If we cannot have a report, I want the content of this letter deliberated in public, and I want the in front of committee to respond to it by the end of February.
First of all, now that there's another motion, I want to speak to that.
I feel strongly that a letter is not required here. I see nothing wrong with having a report. When we last spoke to these witnesses, we specifically asked them whether or not this met the criteria to be a recommendation, and this topic was a recommendation. We did that about five or six times, and I believe all members on the committee, all three major parties, did that. Recommendations came forward. Recommendations usually go in a report; they don't go in a letter. The word “recommendations” was used. I jotted a number of things down in my own notes that I remember witnesses saying at the time.
In the spirit of collaboration, I was of the understanding that while we're having the four meetings this week on medical inadmissibility, we would possibly be able to have another meeting to look at hearing directly from the Yazidi women who have been injured or persecuted by the situation they've been put through, and that we would be able to hear about, and Canadians would get a better feel for, the need for the changes that may be required. They're not that outstanding, given the number of people involved, as we've seen in the admissibility situation this evening.
I strongly believe that there is a need to have this recorded as a report, as opposed to an open letter, for the accountability of the whole process. We have a responsibility as Canadians and as members of the backbench and the opposition to make sure that the recommendations are going forward. The government doesn't have to act on them. I believe that they probably would, in some cases, make some adjustments in the whole process.
I think it's very reasonable to ask for that letter to be dealt with. We've already seen, I believe, some of what would be public in it. We could put those forward, if we were to secure another meeting with witnesses to have the opportunity to strengthen what would go into the recommendations. It then gives us an opportunity to be able to respond to it.
I think the motion put forward by my colleague, Ms. Rempel, is the best that you could get out of the amendment the government side has brought forward, the backbench committee from the Liberal government, regarding wanting to have a letter, particularly when it was apparent that it was already coming. I can't believe that the recommendations that everyone in this room knows are already out there couldn't be accepted. They're on the table already. They were there the last time we met two weeks or 12 days ago. I believe that we could live with the opportunity of developing those recommendations in the committee, and then have the minister come and appear before us to deal with such an important issue—the government is the one that said they would bring in 1,200 Yazidi women—and to move as quickly as we can to accomplish the goal the government has set for itself.
I think the witnesses all know the difference between a report and a letter, and I think they would feel much more included in the whole process if they knew that there was going to be a report. They witnessed what happened 11 or 12 days ago at the last meeting that we had. I believe it would be very valuable for the government to have this in their hands as a report.
I'll leave it at that for now and see if there are any other concerns, but I would certainly recommend that we drop both amendments and go back to the original motion.
Mr. Chair, the last time this committee wrote a letter was following the hearings we had in the summer of 2016. There was at that time, I believe, a desire to do more. What ended up happening was that this committee wrote a letter to the minister. It was a self-congratulatory do-nothing letter.
I'm looking at a CBC article here right now. This letter came out July 22, 2016, with no requirement for a response. One of my colleagues' offices had said that it was the best that could be done right then. It took another four months of browbeating to come up with some sort of a motion or a solution and then another year.... We're now a year and a half into this.
I don't find it acceptable that the government feels that their response to this situation is a self-congratulatory letter that requires no government response. This is not what the resettlement services agencies need. This is not what these women need. They need help now.
Mr. Chair, you have done good work in chairing other committees. You have been very passionate on some of these issues. To prove my colleague, Mr. Sarai, wrong in saying that this is somehow Conservative theatrics, I would implore you and I would ask you to talk to your colleagues. Suspend the meeting briefly. Hopefully they can caucus. There is no reason why there cannot be a report. The Liberals have a majority on this committee and they can write whatever they want. I want the government to be required to respond to the testimony that was put forward at this committee. That is what members of Parliament do. A self-congratulatory letter disrespects the community effort that is being put forward to help these people and it disrespects the government actually doing something on this particular file.
Canada should be developing best practice on this, not trying to sweep this problem under the rug. We had this committee meeting, hopefully, to do something that resembled work and get some help out. A self-congratulatory letter that is developed in secret and that requires no government response does not do that. I will be before this committee every single time, every time we hear an issue, every single time something happens in the community, reminding the members of the fact that we wasted time and we wasted the resources of the government in closing our response to this with a nice, flowery letter from Liberal members, who are listening to staffers and the centre, to the minister.
If this is what the members want to do, if they just want to push this away.... I'm sure they have something drafted already. I ask you, as the chair, to perhaps talk to some of the other members on this team. They can write whatever they want in this report. They have the majority on this committee. It can be there. There is no reason why we would not have a report, or not have the minister come to committee, outside of the government wanting to hide this or sweep this under the rug.
Yes, I'm going to get theatrical about this Randeep, because I don't get this. I don't get why this is the fourth time we've had to go through this conversation. I don't get why you've given me half an hour on camera to get angry at you when you could have just voted to have a report. The government will respond. We'll make sure that the minister gets here somehow. Why don't you just let the government respond in a written report? This is insanity, it's lunacy, and it's not what we should be doing with a parliamentary committee.
I ask you, Mr. Chair, to take even five minutes, and maybe people across the aisle will want to caucus for a minute and talk about something that is more reasonable than what's on the table right now.