April 4th is the anniversary of a landmark Supreme Court of Canada decision in 1985: Singh v. Minister of Employment and Immigration. The Singh decision recognized that the Canadian Charter of Rights and Freedoms protected the fundamental rights of refugees.
International migrants make up approximately 3% of the world population (191 million in 2005). The number of migrants is growing quickly, with an increase of 36 million international migrants between 1990-2005. In 2012, Canada was the world’s seventh largest recipient of new refugee or asylum-seekers, with 20, 500 claims. These numbers show that migrants and refugees are here to stay – and that their rights must be protected.
Unfortunately, here in Canada, refugee rights are under threat. The federal government’s decision to cut health benefits to many refugees last year is resulting in many negative health outcomes as is being illustrated in the Refugee Health Outcome Monitoring and Evaluations System (Refugee HOMES). These adverse and inequitable consequences were predicted in our Health Equity Impact Assessment, and unfortunately they are coming to pass. Since refugees have experienced persecution in their home country, they may already be health disadvantaged – particularly in terms of employment opportunities and in areas of mental health – when they arrive in Canada. Therefore, stripping refugees of health care places them in an even more precarious status than they already are.
Different levels of government have the policy levers to mitigate and lessen the adverse impacts of the cuts to the Interim Federal Health Program (IFHP).
At the federal level:
- Most fundamentally, the government should rescind the cuts to IFHP;
- Respond to the cases that have been reported by Canadian Doctors for Refugee Care and convene a roundtable to identify opportunities to collect data more systematically; and
- Respond to the concerns about cuts to the IFHP raised by numerous professional health care associations.
At the provincial level:
- Formally commit, as Quebec has done, to ensuring that refugees no longer supported by IFHP are not denied care;
- Measure and report on the negative health outcomes caused by cuts to the IFHP;
- Track financial price of the changes to the IFHP through increases in preventable emergency room visits; and
- Review their existing policies on eligibility for provincial/territorial health coverage to ensure that they do not negatively impact immigrant and refugee health.
Regional Health Authorities also play a role. They can:
- Ensure that refugees are not denied care;
- Endorse the documentation of impacts and adapt the Refugee HOMES documentation tool; and
- Enable or require health care providers to document cases and track additional costs incurred in serving refugee patients.
The Canadian Council for Refugees has set up a mechanism where people can show their support in protecting the rights of refugees here.