Doctors demand changes to proposed refugee health policy

Doctors across Canada are outraged that the federal government plans to eliminate health care services for some refugee claimants and limit the care provided to others. Many are now talking about taking action to protest against the move.

The plan, introduced by Citizenship and Immigration Minister Jason Kenney, means refugees fleeing unsafe countries would only be entitled to "urgent or essential services." Some refugees would be denied all care, unless they have a disease such as tuberculosis, which would pose a risk to public health.

The move is scheduled to take effect at the end of next month.

"This is a dramatic change," says Dr. Meb Rashid, director of The Crossroads Clinic at Women’s College Hospital in Toronto.

The clinic, which is affiliated with the University of Toronto, opened its doors about five months ago specifically to provide health care to refugees. It now has about 300 patients, who come from dozens of countries.

No access to medications

"My biggest concern is they won’t have access to medications," Rashid says. "Some people will get very sick and we hope no one dies from this, but it is certainly a possibility."

The Interim Federal Health Program offers basic health coverage to protected persons, refugee claimants and others who don’t qualify for provincial or territorial coverage. Last year it cost $84 million. The government says scaling it back will save about $100 million over the next five years.

The plan means some refugees will be denied all health services, except in cases where public health is at risk, according to Ana Curic, spokesperson for Jason Kenney. Still others will no longer receive supplemental benefits such as medications, dental care, vision care and mobility devices.

Pay or go without

That means refugees who are diabetic or who require medicine for chronic diseases or to treat infections will have to pay for it themselves or go without.

"There’s a tremendous irony in that we’ve had patients come from refugee camps where they’ve had access to NGOs [non-governmental organizations] who’ve been able to give them diabetic medication or hypertension medications and then we invite them here, and what happens? They don’t have access to medications," Rashid says.

In a news release, Kenney rationalized the move by saying Canadians should not pay benefits for refugees that "are more generous than what they are entitled to themselves." 

He added the move would also deter fraudulent refugee claimants from coming to Canada.

Mean-spirited move

But Rob Shropshire, interim director of the Canadian Council for Refugees, based in Montreal, calls the move "mean-spirited."

"It’s picking on vulnerable people who are coming here to escape torture, persecution, war and they are coming here to try to find safety and build a new life," he says.

He says Kenney appears to be pitting Canadians against refugees.

"It fans misunderstanding of who refugees are and why they come here," he adds. "It promotes an image that refugees are bogus fraudsters and in fact that is not the case."

Dr. Wendell Block has worked with refugees and with the Canadian Centre for Victims of Torture in Toronto for more than 25 years. He says many suffer from Post Traumatic Stress Disorder, have lost their families, faced torture, rape and other kinds of trauma.

He said they need both physical and mental health care to heal and start a new life here.

‘It’s going to be very, very difficult," says Block. "The folks I see are going to be set back by this policy, no doubt, no doubt about it."

Patients will become sicker

He predicts the plan will backfire, adding that those who are denied health care and drugs will become sicker, making it difficult for them to integrate into Canada and become productive citizens.

"If you are sick or in chronic pain, and you cannot get help when you arrive, you are not going to be able to do the jobs that require physical labour," he says, adding that over time, many will deteriorate and eventually require hospitalization.

Shropshire says it’s unclear whether provincial governments will be asked to cover off some of the costs. He says he plans to meet with federal officials next week to get more details on just how the plan will roll out.

Block and Rashid say they will continue to treat patients as best they can, but the problem comes when they can’t refer them to specialists or order laboratory or diagnostic tests.

Meanwhile, Rashid and Block and dozens of other doctors across Canada are considering collective action to raise awareness of the issue across Canada.

"I think many of us feel the need to step up and inform people of the consequences," Rashid says.

"These are folks who have lived through unimaginable trauma," he says. "Just from a point of decency, to cut those people off from the care that they need just doesn’t seem like the Canada that I know."