Refugee health-care advocates criticize government inaction

The federal government hasn't complied with a court ruling that reinstated health care for refugee claimants, advocates are set to argue in court next week, returning to a fight they thought they'd won last July.

Lorne Waldman, a lawyer for Canadian Doctors for Refugee Care, will be back in Federal Court on Tuesday to try to force the government to comply with a July 2014 decision that reversed changes to refugee health care introduced two years earlier.

In 2012, the federal government decreased the level of health care to which refugee claimants were entitled, arguing the government shouldn't pay for health care for "bogus" refugee claimants.

Canadian doctors took issue with the government's distinction between "bogus" and "genuine" refugees, arguing that the changes brought in 2012 also applied to those claimants whose applications are being processed and who are in the queue waiting for a hearing.​

The Federal Court found the move was "cruel and unusual" because it jeopardizes refugees' health and shocks the conscience of Canadians.

Judge Anne Mactavish ruled the federal cabinet has the power to make such changes and that the procedure was fair, but that the 2012 modifications put lives at risk, including the lives of children.

Mactavish gave the government until Nov. 4 to reinstate the health care. The government waited until the last possible day to return some health care to refugees pending its appeal to the Federal Court of Appeal.

Mactavish's ruling also rolled back a change the Conservatives made to a 1957 Cabinet order that provided for refugee health care. The government had repealed that measure when it made the changes in 2012.

Government appealing 'flawed' ruling

The Canadian Association of Refugee Lawyers and the Canadian Doctors for Refugee Care, however, say the government re-repealed that measure on Nov. 6, 2014, only two days after it was supposed to restore the health coverage.

The advocates first pointed out the return to the repealed measure in December, but the Canadian Medical Association Journal drew attention to it in an article published Wednesday.

Waldman said the Federal Court was clear the government was supposed to restore the pre-2012 coverage. He's filed a motion to the court asking for a finding that the government has breached the court order.

A spokesman for Immigration Minister Chris Alexander declined an interview request and responded by email. He called the court ruling "flawed."

"Our government is defending the interests of Canadian taxpayers as well as the integrity of our refugee determination system," Kevin Menard wrote.

"We have implemented temporary health-care measures as per the Federal Court’s ruling on Nov. 5. Regrettably, the Federal Court’s ruling is costing taxpayers an extra $4 million a year."

Government showing 'contempt'

Dr. Philip Berger, one of the founders of Canadian Doctors for Refugee Health, says the government showed contempt for refugee claimants and doctors and is now extending that contempt to the Federal Court.

"There's nothing the federal government says about refugee health that can be believed," he said.

"The costs have simply been downloaded to the provinces and to hospitals who must see people in emergency departments and doctors who are prepared to provide coverage for free."

The lack of early intervention also costs more as problems get worse, said Berger, the medical director of inner-city health at St. Michael's Hospital in Toronto.

The original Federal Court case covered a number of specific examples of refugee claimants being denied health care, including a woman in labour who was denied an epidural.

"What the government underestimates is that we, the doctors, are more stubborn than they are, but our cause is just and theirs is not," Berger said.