For immediate release
Over 50 Prominent Canadian writers and artists sign declaration calling on federal government to reverse refugee health cuts
Dr. Vincent Lam, Adrienne Clarkson, and Kiefer Sutherland among those pledging support on eve of 2nd National Day of Action
Toronto, June 13, 2013 – The campaign for refugee health care gained some high profile new support today as dozens of prominent Canadian writers were joined by actors, filmmakers, and musicians in signing a declaration which calls on the federal government to reverse its cuts to the Interim Federal Health Program. It has been almost one year since the government made changes to the program which has left many patients – including sick children and pregnant women fleeing sexual violence – suffering.
“As a physician, and as a Canadian, it is unacceptable to me that refugees in need of health services are being denied care,” said award winning author Dr. Vincent Lam. “I stand proudly with my colleagues in the medical and arts communities in calling on the federal government to reverse these harmful cuts.”
Among other signatories to the declaration, Speaking up for Canada – Opposing cuts to health services for refugees, are authors Margaret Atwood, Yann Martel, and Rohinton Mistry, actors Shirley Douglas and Kiefer Sutherland, musician Jian Ghomeshi, and former Governor General Adrienne Clarkson and her husband, writer John Ralston Saul.
As the declaration notes, “refugees arriving in Canada – many of whom are fleeing war, violence, or famine – often come with little more than the clothes they are wearing. Access to basic health services is guaranteed to them under the Charter; care has been provided because it is the right thing to do.”
A National Day of Action is being planned in 19 cities across Canada on Monday, June 17th. Dr. Lam will be speaking at the event in Toronto. Please visit http://www.doctorsforrefugeecare.ca/day-of-action-june-17-2013.html for detailed information.
“This campaign began with a few physicians expressing alarm over the health impacts of federal cuts to refugee care,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “As a result of the government’s continued intransigence and mendacity, the campaign has attracted a diverse coalition of Canadians who believe there is no place for these reckless cuts in a fair and generous society.”
The declaration and a complete list of signatories follow.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal, Empower Consulting
416-996-0767
Christopherholcroft@hotmail.ca
Speaking up for Canada – Opposing cuts to health services for refugees
Canada has a proud humanitarian tradition.
We offer refuge to those seeking safety, rights to those seeking justice, and care to those who are ill. Yet these principles which define us are being undermined by a policy change that is delivering real harm to a vulnerable
population.
On June 30th, 2012, the federal government made cuts to the Interim Federal Health Program that have resulted in important health services for refugees being eliminated or restricted.
Refugees arriving in Canada – many of whom are fleeing war, violence, or famine – often come with little more than the clothes they are wearing. Access to basic health services is guaranteed to them under the Charter; care has been provided because it is the right thing to do.
Now, due to these cuts, many refugees – future citizens of this country – are being denied services, including children and pregnant women. The non-profit organization Canadian Doctors for Refugee Care has documented many such unacceptable cases on their website. The federal cuts have also sown confusion within our health system, further restricting access to care for
refugees and resulting in unnecessary costs being borne by provincial governments.
This is not the Canadian way.
We call on the federal government to reverse these health cuts and restore our country’s humanitarian tradition of providing care to refugees.
On June 17th, please join us and Canadian Doctors for Refugee Care in participating in a National Day of Action. There are events taking place in cities across the country. To learn more, please visit www.doctorsforrefugeecare.ca.
Signatures
Stephen Andrews
Sara Angel
Margaret Atwood
Jack Batten
John Bemrose
Randy Boyagoda
Joseph Boyden
Cathy Marie Buchanan
Stevie Cameron
Wayson Choy
Adrienne Clarkson
Karen Connelly
Erika de Vasconcelos
Shirley Douglas
Sarah Elton
Will Ferguson
Ken Finkleman
Charlie Foran
Richard Fung
Jian Ghomeshi
Camilla Gibb
Don Gillmor
Lee Gowan
Charlotte Gray
John Greyson
Rawi Hage
Marjorie Harris
Lawrence Hill
Miranda Hill
Naomi Klein
Vincent Lam
Michele Landsberg
Kyo Maclear
Yann Martel
Ashok Mathur
Ken McGoogan
Rohinton Mistry
Michael Ondaatje
Katrina Onstad
Ian Iqbal Rashid
Nino Ricci
Robert Rotenberg
Kerri Sakamoto
John Ralston Saul
Emily Schultz
Philip Slayton
Linda Spalding
Kiefer Sutherland
Madeleine Thien
Miriam Toews
Jane Urquhart
For immediate release
Health care workers in 17 cities across Canada to call for restoration of refugee health services as part of second National Day of Action June 17th
Toronto, June 10, 2013 – Canadian Doctors for Refugee Care is holding a second National Day of Action on June
17th to call on the federal government to reverse the reckless cuts to refugee health care. It has been almost one year since the government made changes to the Interim Federal Health Program (IFHP) which has left many patients – including sick children and pregnant women fleeing sexual violence – suffering. Due to overwhelming interest, events will be happening in at least 17 cities across the country. These events are a demonstration of health care workers and allies’ unwavering support of refugee patients and ongoing opposition to the IFH cuts.
“Our message to the federal government is clear – we are not going away,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “This year even more cities are participating and we will continue our campaign against these punishing and costly cuts.”
Canadian Doctors for Refugee Care has documented many cases of people being denied care including pregnant women and sick children. Eight months ago, the group submitted a written proposal to Citizenship, Immigration, and Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The group has yet to receive any response to its proposal.
This year’s events are being guided by a new generation of health care workers, as medical residents and students are taking the lead in organizing in many cities. In fact, in an unprecedented move, two universities – McGill and the University of Toronto – are facilitating learner participation in the National Day of Action.
“We are trained to treat people based on their disease, not their country of birth or refugee category,” said Dr. Vanessa Redditt, family medicine resident, University of Toronto. “The government should not be asking us to deny care to those who need it.
This is ethically unacceptable and has devastating health consequences. We will continue to provide care to these patients and, as importantly, to advocate on their behalf.”
“These young doctors will see the tragic consequences of this policy change over and over through the course of their careers unless the federal government reverses course,” said Meb Rashid, medical director of the Crossroads Clinic at Women's College
Hospital.
Over 20 health care organizations continue to support this campaign. Physicians, nurses, community health workers and many others from different professional health disciplines will be joining students and other Canadians participating in
demonstrations on Monday, June 17th.
Please see a list below of participating cities and visit http://www.doctorsforrefugeecare.ca/day-of-action-june-17-2013.html for further updates on these and additional events:
- Victoria - 4pm; South East corner of Douglas Street and Fort Street - contact: Victoria4refugeehc@gmail.com
- Vancouver - Noon; in front of the regional Citizenship and Immigration office, 1148 Hornby Street - contact:
vancouver4refugeecare@gmail.com
- Calgary - 10am; press conference in the Eau Claire Market Community Space - contact: juliabietz@yahoo.ca
- Edmonton - Noon; in front of the Alberta Legislature - contacts: dallasdyson@hotmail.com or bamohame@ualberta.ca
- Saskatoon - Noon; gathering at the bandshell in Kiwanis Park, then marching across the University Bridge to the Royal
University Hospital - contact: saskrefugeehc@gmail.com
- Winnipeg – Noon; public press conference in Central Park, near the fountain – contact: mdillon@mts.net
- Thunder Bay - Details TBC - Contact: obabalola@nosm.ca
- Sudbury - Details TBC - Contact: obabalola@nosm.ca
- Windsor - Details TBC
- Kitchener - Noon; in front of Kitchener City Hall - 200 King Street West - contact: kwrefugeehc@gmail.com
- Hamilton - 1:00 pm; in front of the regional Citizenship and Immigration office, 55 Bay Street North - contact:
hamiltonnoifhcuts@gmail.com
- Toronto - Noon; in front of the Canadian Citizenship and Immigration office, 25 St. Clair Avenue East - contact: docs4refugeehc@gmail.com
- Kingston - Noon; meet beside the water fountain at the corner of King Street and Market Street in Springer Market Square - contact: cbrace@qmed.ca
- Ottawa - Noon; on Parliament Hill - contact: ottrefugeehc@gmail.com
- Montreal - Noon; at Complex Guy-Favreau - contact: Helen Hsu at kanneikyo@gmail.com
- Halifax - 12:30 pm. at the Grand Parade - contact: halifaxrefugeeclinic@gmail.com
- St. John's - Details TBC
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
MCGILL BECOMES SECOND UNIVERSITY TO FACILITATE LEARNER PARTICIPATION IN NATIONAL DAY OF ACTION
Please see e-mail sent to students of McGill from Associate Dean below.
Dear Students –
The Canadian Doctors for Refugee Care (CDRC) is organizing a second National Day of Action on Monday June 17, 2013 to protest
the refugee health care cuts, which now includes 13 cities. Much of the preparation in Montreal is being led by residents and medical students. The Montreal protest will be held at Complex Guy-Favreau, from 12h00 – 14h00. McGill University cannot take political positions on this or other matters. However, students are taught to be advocates for their patients and this is an excellent opportunity to do so. At the students’ request, I permit you to attend the National Day of Action. Please advise your supervisors if you would like to attend. The Faculty will send out a notification to facilitate this. You will be relieved for a short time from your
usual responsibilities from 11h30 – 14h30 for travel to and from the event.
For the Class of 2016: You have a case conference scheduled at 14h35. You are expected to be back for this. Toby will arrange for the case to be released earlier in the day than usual to allow you time to complete it. More information on the CDRC
is listed at the end of this communication.
Robert Primavesi, MDCM, FCFP(EM)
Associate Dean
Undergraduate Medical Education and Student Affairs
Faculty of Medicine, McGill University
3655 Promenade Sir William
Osler Montréal, QC, Canada H3G 1Y6
CDRC:
Canadian Doctors for Refugee Care is an incorporated group of non-partisan physicians from across Canada , most of who treat refugees. CDRC was established in the spring of 2012 as an advocacy group singularly focused on persuading the federal government to rescind severe cuts to health care coverage for refugee claimants under the Interim Federal Health program. CDRCis also a co-litigant in a Charter challenge to the cuts. Prior to the cuts which took effect June 30, 2012 and
since 1957, IFH provided insurance coverage to refugee claimants for the full breadth of health services and medications and equivalent to that received by people on welfare. CDRCseeks to reverse the cuts or change them so that basic health benefits are restored to refugee claimants.
Organizations opposing cuts to refugee health care:
i. College of Family Physicians of Canada
ii. Royal College of Physicians and Surgeons of Canada
iii. Canadian Association of Optometrists
iv. Canadian Association of Social Workers
v. Canadian Dental Association
vi. Canadian Medical Association
vii. Canadian Nurses Association
viii. Canadian Pharmacists Association
ix. Canadian Association of Community Health Centres
x. Canadian Doctors for Medicare
xi. Canadian Association of Midwives
xii. Registered Nurses Association of Ontario
xiii. Canadian Federation of Nurses Union
xiv. Canadian Psychiatric Association
xv. Canadian Paediatric Society
xvi. Association of Medical Microbiology and Infectious Diseases Canada
xvii. Médecins du Monde
xviii. Public Physicians of Canada
xix. Ontario’s Council of Medical Officers of Health
xx. Canadian Association of Occupational Therapists
xxi. Canadian Association of Emergency Physicians
UNIVERSITY OF TORONTO FACULTY OF MEDICINE FACILITATES LEARNER PARTICIPATION IN NATIONAL DAY OF ACTION
The memo below was signed by the Vice Dean Post Graduate Medical Education and an identical memo was signed by the Vice Dean Under Graduate Medical Education, Faculty of Medicine , University of Toronto.
The Faculty's memo should serve as an exemplar for faculties of medicine across Canada and is a bona fide expression by the Academy of support for learners who choose to engage in the CanMEDS role of physician as Advocate. Please distribute widely to Deans and Vice Deans of Faculties of Medicine and other health discipline faculties and to student/ resident associations.
This is an unprecedented and welcome move by the university.
________________________________________________________________________________________
Dear Colleagues
I am writing to ensure you are aware of the following information regarding refugee health care.
The Canadian Doctors for Refugee Care is organizing a second National Day of Action on Monday June 17, 2013 to protest the refugee health care cuts, which now includes 13 cities. The Toronto protest will be held at 12 noon ( for 1 hour) at the Citizenship and Immigration Canada building, 25 St. Clair East near Yonge. Much of the preparation in Toronto is being led by residents and medical students at University of Toronto, with the support of faculty.
You will know of course that the University of Toronto cannot take political positions on this or other matters. However,
it is important that our Departmental and Education leads are aware that this event is taking place.
Regarding the participation of our learners, we would like to respectfully request the following: If a learner requests permission to attend the National Day of Action, we would ask you to facilitate this where possible. Please advise your faculty and supervisors that there may be learners in UGME and PGME who would like to attend, and that we should facilitate this. Our learners will need to be free (11:30 AM- 2:00 PM) and be relieved for a short time from their usual responsibilities for travel to and
from the event. (Please allow appropriate travel time based on the site of rotation.)
More information is listed at the end of this communication.
If you need further information regarding this National Day of Action please contact:
Philip B. Berger, MD
Chief, Department of Family & Community Medicine
Medical Director, Inner City Health Program
Associate Professor, University of Toronto
St. Michael's Hospital
30 Bond Street
Toronto, ON M5B 1W8
Phone: (416) 867-3712
Fax: (416) 867-3739
E-Mail: bergerp@smh.ca
CDRC:
*Canadian Doctors for Refugee Care is an incorporated group of non- partisan physicians from across Canada , most of who treat refugees. CDRC was established in the spring of 2012 as an advocacy group singularly focused on persuading the federal government to rescind severe cuts to health care coverage for refugee claimants under the Interim Federal Health program. CDRC is also a co-litigant in a Charter challenge to the cuts.
*Prior to the cuts which took effect June 30, 2012 and since 1957, IFH provided insurance coverage to refugee claimants for the full breadth of health services and medications and equivalent to that received by people on welfare. CDRC seeks to reverse the cuts or change them so that basic health benefits are restored to refugee claimants.
*Refugee claimants , many who will become Canadian citizens, are being denied necessary health services including prenatal care, acute and follow up care for medical emergencies such as heart attacks and routine preventive services. Since June 30, 2012 CDRC has independently verified over 50 cases of claimants being denied services including for example an epidural for a woman in labour, an ultrasound for a woman with fibroids and heavy vaginal bleeding and chemotherapy for cancer patients. Denial of services will cost more by allowing treatable conditions to progress, leads to more and preventable emergency department visits and places doctors in the position of having to treat patients on the basis of their legal status and country of birth, rather than medical need. As a simple matter of fairness to refugee claimants - many who have fled horrendous conditions , have neglected their health and are legally within our borders-health care should be provided to this needy and vulnerable group.
* CDRC will advocate for refugee health care coverage over the next 30 months until the next federal election.
* CDRC will continue to conduct its advocacy activities across Canada at public meetings, in meetings with legislators, at medical conferences, on university campuses, in hospitals /community clinics and at demonstrations.
* CDRC will continue to: document cases of refugees being denied services, hold meetings with interested legislators, educate the public and health discipline students about the effects of the cuts, write articles in medical journals and opinion pieces in the lay press, organize protests against the cuts, engage the media ( CDRC members have been interviewed hundreds of times and is largely responsible for the high profile of this issue) , assist postgraduate university students who are studying the issue, participate as speakers on panels and other educational events, inform colleagues about how the new IFH system works, field regular calls from health professionals across Canada about individual cases of hardship resulting from the cuts, secure services pro bono where CDRC is able, work with other refugee/immigrant organizations on this issue, advise over 20 national health associations who oppose the cuts, seek the assistance of faith based groups--all with the sole purpose of restoring health coverage to refugee claimants.
Organizations opposing cuts to refugee health care:
i.College of Family Physicians of Canada
ii.Royal College of Physicians and Surgeons of Canada
iii.Canadian Association of Optometrists
iv.Canadian Association of Social Workers
v.Canadian Dental Association
vi.Canadian Medical Association
vii.Canadian Nurses Association
viii.Canadian Pharmacists Association
ix.Canadian Association of Community Health Centres
x.Canadian Doctors for Medicare
xi.Canadian Association of Midwives
xii.Registered Nurses Association of Ontario
xiii.Canadian Federation of Nurses Union
xiv.Canadian Psychiatric Association
xv.Canadian Paediatric Society
xvi.Association of Medical Microbiology and Infectious Diseases Canada
xvii.Médecins du Monde
xviii.Public Physicians of Canada
xix.Ontario’s Council of Medical Officers of Health
xx.Canadian Association of Occupational Therapists
xxi.Canadian Association of Emergency Physicians
Sincerely,
Salvatore M. Spadafora, MD, FRCPC, MHPE
Vice Dean
Post Graduate Medical Education
Faculty of Medicine, University of Toronto
Room 602, 500 University Ave.
Toronto ON M5G 1V7
For immediate release
Canadian Doctors for Refugee Care says Interim Federal Health Program in crisis on Refugee Rights Day
Group plans second National Day of Action June 17th to take message to the streets
Toronto, April 4, 2013 –Canadian Doctors for Refugee Care is marking Refugee Rights Day by releasing more examples of refugees being denied necessary health care because of federal cuts and confusion surrounding the Interim Federal Health Program (IFHP). These are new cases reported since Canadian Doctors for Refugee Care joined with the Canadian Association of Refugee Lawyers to launch a Charter challenge to the federal government’s cuts to refugee health care.
As hospitals, community clinics, medical professionals, and provincial governments continue to struggle with the incomprehensible structure of the revised IFH program individual patients – including sick children and pregnant women fleeing
sexual violence – are suffering. This includes the recently publicized case of a Calgary woman who was denied cancer treatment.
“We are finding more and more patients legally here having to go without badly needed health care services,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College Hospital. “The patients we see have fled unimaginable terror to seek a safer life in Canada, and our government is telling doctors that they cannot provide necessary treatment.”
It has been six months since Canadian Doctors for Refugee Care submitted a written proposal to Citizenship, Immigration, and
Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The group has yet to receive any response to its proposal.
Canadian Doctors for Refugee Care is organizing a National Day of Action for June 17th to take the facts directly to the streets and tell Canadians the consequences of the federal government’s cuts to refugee health care.
“The Conservative government is failing many sick refugee children and women,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “These refugee families are legally within our borders and the government has a Charter responsibility to provide them with basic health care coverage. Life saving medication and prenatal care is not gold plated
health care. The government should finally start telling the truth.”
The following is a sample of cases catalogued by Canadian Doctors for Refugee Care in which refugees have been refused coverage and care. Every case has been verified.
· a woman with severe Post Traumatic Stress Disorder as a result of sexual violence in her country of origin cannot be treated because she has to wait for her IFH coverage to be initiated
· a man is found to have a mass in his liver after an Emergency room visit. He does not have any insurance to follow up because he is from a Designated Country of Origin (DCO) and cannot pay for it himself
· a woman fleeing the sex trade arrives in the late stages of pregnancy and cannot get any testing as she awaits her IFH coverage
· a six year old child cannot get proper investigations for a possible urinary tract infection as she awaits her IFH coverage. The family cannot pay for the treatment
· a woman with a biopsied mass in her neck cannot get a follow up appointment to get her results even though she has health coverage through the IFHP
· a woman with a large mass in her pelvis cannot get diagnostic or curative surgery because she is denied refugee status during the work-up
· a woman in labor is asked to pay for the cost of her epidural as the anesthetist is unable to understand her IFHP insurance coverage late at night. She delivers her baby without pain control
· a woman requiring treatment of fibroids and heavy vaginal bleeding is denied coverage for a necessary pelvic ultrasound.
“The government should listen to the 20 national health care organizations as well as that of many provincial governments and
rescind these cuts now,” added Dr. Rashid.
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / ChristopherHolcroft@hotmail.ca
March 8th
Letter to Minister Kenney re: IFHP cuts from the Catholic Health Alliance of Canada - http://www.chac.ca/letter%20to%20minister%20kenney%202013.pdf
Young resident doctors lead a nation-wide protest against the cuts to refugee healthcare
Healthcare providers, led by young resident doctors, mobilized across the country on December 15 to oppose the next phase of cuts to the Interim Federal Health Program, which dramatically restrict healthcare coverage for some refugees. On December 14, Immigration Minister Kenney released the first list of 27 “safe”countries, from which refugee claimants will be fast-tracked with no right of appeal and who will receive no healthcare coverage, except for conditions deemed a threat to public health and safety.
Healthcare professionals—from physicians to midwives to pharmacists—are calling on the federal government to reinstate equitable healthcare coverage for all refugees.
Over 80 healthcare providers gathered for a candlelight vigil at Toronto's Nathan Phillips Square to demand that the Interim Federal Health Program be immediately and fully restored. They collected signatures on a 6 foot holiday card, as well as
individual holiday cards, addressed to Minister Kenney calling for a reversal of the cuts to refugee healthcare and continued their protest into the crowded Eaton Centre.
In Vancouver, approximately 50 individuals gathered at the Immigration and Refugee Board offices to hold vigil for 2 hours.
Community and health care workers spoke against the cuts while passersby signed cards of protest for the Minister of Citizenship, Immigration, and Multiculturalism. Similar events took place in Montreal, Winnipeg, and Kingston.
“Cutting refugee health care is an unfair and costly decision that goes against Canadian values and will lead to devastating consequences for some of the most vulnerable of our society,”explained Residents for Refugee Care.
The physicians and healthcare providers have pledged to follow the impact of these cuts and report them over the coming months.
Media Advisory
Attention: Assignment desks, health and immigration reporters
Resident Doctors will hold candlelight vigil to protest next phase of refugee health care cuts
Healthcare providers will join doctors in training in holding a candlelight vigil December 15th to mark the implementation of the next phase of cuts to the Interim Federal Health Program (IFHP). The peaceful demonstration will offer the public the opportunity to write “cards to the Honourable Jason Kenney” to request their holiday wishes for reinstating health coverage for refugees. On
December 14th, the Minister of Citizenship, Immigration and Multiculturalism Jason Kenney released the Designated Country of Origin (DCO) list; new refugee claimants from countries on this list will have no health care coverage except for conditions that pose a threat to public health or safety. The DCO list includes countries that the government arbitrarily deems “safe”,
notwithstanding the potential for persecuted minorities within these countries.
This latest phase of cuts to the IFHP will make some of the most vulnerable people in our country even more vulnerable. For example, heart attack victims who are refugee claimants from countries on the DCO list will have no access to lifesaving treatment; pregnant women will receive no health care. Healthcare providers speaking out against the cuts to refugee health services are calling on the federal government to reinstate equitable health care coverage for all refugees and refugee claimants.
Who: Medical residents, students, physicians, other healthcare providers and any supporters of refugee health care
What: White coat candlelight vigil to protest the next phase of federal cuts to refugee health services.
When: December 15th, 4:00 pm
Where: Speaker’s Corner, Nathan Phillips Square, Toronto City Hall, 100 Queen Street West
Why: Cutting refugee health care is an unfair and costly decision that goes against Canadian values and leads to devastating
consequences for some of the most vulnerable of our society
Smaller events are being organized in other cities:
· Montreal: 4 pm in front of the Eaton Centre;
· Vancouver: 1pm in front of the CIC offices at 300 W Georgia St (near the library); contact is Thomas Warren -- tom.mackenzie.warren@gmail.com
· Kingston: 11 am in front of City Hall; contact is Chantalle Brace -- cbrace@qmed.ca
· Calgary: TBD; contact is Dr. Jia Hu -- jiahu17@gmail.com
Further background information on the Interim Federal Health Program cuts is available at: www.doctorsforrefugeecare.ca.
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For more information please contact:
On-site
Dr. Alexander Caudarella: 647-463-2539; resrefugeecare@gmail.com
Dr. Hasan Sheikh: 647-985-9454; resrefugeecare@gmail.com
Christopher Holcroft – Principal, Empower Consulting; Cell: 416-996-0767/ Chris_Holcroft@yahoo.com
Please see this statement from the Canadian Healthcare Association:
http://www.cha.ca/wp-content/uploads/2012/11/IFHP-reform-policy-statement-November-2012.pdf
For immediate release
Canadian Doctors for Refugee Care warns of more chaos, serious health risks to come
Toronto, December 4, 2012 – With the federal government announcing that it will be revealing its Designated Countries of Origin list to inform its handling of refugees on December 15th, Canadian Doctors for Refugee Care is warning provincial governments, medical professionals and health institutions to brace for more chaos and cases of individuals not being eligible for care. The announcement is particularly disheartening given the government’s unwillingness to meet with health care organizations to talk about the difficulties the changes to the Interim Health Program (IFHP) have already caused, or consider alternative options.
On October 2nd Canadian Doctors for Refugee Care submitted a written proposal (outlined below) to Citizenship, Immigration, and Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The same proposal was previously sent to Dr. Danielle Grondin, Director General of the Health Branch of the Ministry of Citizenship, Immigration, and Multiculturalism on July 31. To date, Canadian Doctors for Refugee Care has received no direct response to its proposal.
The consequences of the government's cuts to refugee health insurance continue to mount. Premier Wall of Saskatchewan has joined the increasing number of voices that have denounced these cuts as being an affront to Canadian values. The recently publicized case of a man denied access to chemotherapy is not an isolated incident. The situation will become much worse
after December 15th.
Once a country is placed on the Designated Countries of Origin list by the Minister of Citizenship, Immigration, and Multiculturalism, refugees from that country who submit a claim after December 15th will only be eligible for health care coverage deemed necessary for public health and safety. There is broad speculation that this list will include Hungary and the Roma refugees fleeing persecution there.
“The number of cases we have seen of patients needing access to, but denied care will be multiples higher after December 15th,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College Hospital. “After that date Canada will be telling some of the most vulnerable people in the world that they are not worthy of basic health care, including for refugees who have heart attacks and pregnant women refugees and their children.”
The group also continues to document an ever escalating number of refugee claimants entitled to IFHP coverage who are being denied health care. Ministerial mismanagement has caused dozens of IFHP-eligible claimants to go without care, and doctors are unable to decipher the impenetrable web of rules and grids established by the Ministry.
Canadian Doctors for Refugee Care has verified every case that has been released to the public.
“The only response by the government has been accusations that Canadian Doctors for Refugee Care is ‘purposefully altering’ the facts of the cases the group has documented,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “As between the doctors and the government it is not the doctors who are engaged in misrepresentation."
The following is a sample of cases catalogued by the Canadian Doctors for Refugee Care in which IFHP entitled refugee claimants have been refused coverage and care:
· A young child from Africa with a high fever but has no health insurance because his IFHP has not been activated
· A woman in her third trimester of pregnancy develops pre-eclampsia, a potentially lethal disease, but has no coverage to treat her condition
· A man with a rectal mass is turned away from care a multitude of times although he should have health insurance according to the government's own policy
· A young child from Africa could not get a chest X-ray after her IFHP was issued but there was a delay in its implementation. She eventually was found to have pneumonia
· A man is scheduled for surgery for a kidney stone causing an enlarged kidney but may have to cancel the surgery as he waits over two months for renewal of his coverage
· Two young children with multiple hospitalizations for asthma cannot get access to their inhalers leaving them at risk for seeking out care through emergency departments
· A woman missed her opportunity to get prenatal screening because she awaits the initiation of IFHP coverage. The baby will be a Canadian citizen.
"Refugee claimants are not tourists or illegal immigrants,” said Dr. Berger. “They are people seeking refuge and safety in Canada; they are here legally, within our borders, doing what they are supposed to be doing. Many will become Canadian citizens. The federal government should rescind the cuts and continue Canada's historical and ethical tradition of caring for refugees."
"It is time to suspend the cuts and find a better and more Canadian way to achieve the government's goal of equity and at the same time protect the health of refugees,” said Dr. Rashid.
Proposal submitted to federal government on IFHP cuts:
Preamble:
· Refugees in any category should have health care coverage equivalent to (and no more than) Canadian citizens in the same economic circumstances.
· In particular, refugee category and country of origin, should not determine access to such health care.
· Everyone residing in Canada with the intent of staying in Canada must have access to such care, both for public health and humanitarian reasons.
· Some sectors of the population have greater health needs including seniors, First Nations peoples, and poorer Canadians and as such require greater care than other Canadians; refugee claimants and refugees similarly require greater care arising from pre migration trauma, poverty, and years of neglected health.
Proposal:
· We propose that a threshold income/asset level to determine eligibility for the Interim Federal Health Program be applied to refugees. This threshold would be determined using a process that acknowledges the unique needs of refugees, but may look to applicable provincial social assistance income/ asset thresholds as a guide.
· Refugees in any category who fall below this threshold should be eligible for health care coverage including all medical services, medications, vision/dental care, medical aides /appliances, and any other benefits provided to social assistance recipients.
· Refugees in any category who do not meet this threshold would still be covered for health services equivalent to those provided under provincial health insurance plans.
· Refugees who do not meet the threshold but who are low-income earners should be eligible for any medication or other expense subsidization equivalent to those provided by provincial subsidization programs.
- Under this proposal equity with Canadians is achieved and refugees in any category will receive necessary health coverage.
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / ChristopherHolcroft@hotmail.ca
For immediate release
Canadian Doctors for Refugee Care releases more cases of vulnerable people being denied access to care; calls on government to put aside rhetoric and resolve issue
Toronto, October 23, 2012 – One month after Canadian Doctors for Refugee Care released a number of examples of patients being denied access to necessary health services due to the cuts to the Interim Federal Health Program (IFHP) and its resulting confusion, the group is releasing another round of troubling cases.
Canadian Doctors for Refugee Care, a non-partisan group of physicians with firsthand experience treating refugees in cities and towns across the country, has been documenting specific patient cases since the changes to federally funded refugee health care services were announced June 30th.
The group is disappointed by the continued lack of a rational response from the federal government to its concerns. Following the last release of documented cases, the government’s public response was to question the group’s methodology and accuse it of having“purposely altered” the facts.
“Rather than trying to discredit the messenger and our evidence-based reports, we encourage the government to put reason over rhetoric and work with us to resolve this issue,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We continue to see the devastating impact of these IFHP cuts on patients and their families, and see the strain this is putting on our public health system.
All cases collected by Canadian Doctors for Refugee Care are provided by the refugee's health care provider. Patients provided consent to their provider to disclose their stories. Their cases were rigorously vetted in some cases by independent chart reviews and by independent interviews with refugees and in other cases by speaking directly with the health care provider. All personally
identifying information has been removed to protect the privacy and identity of the refugee, including age, country of origin, date of arrival and city/province of current residence. Most refugees are too frightened to speak publicly.
In addition to the individual cases that are brought to our attention, we continue to hear about refugees being denied access to health care or medical clinics refusing to treat patients, even with IFHP coverage, because of confusion surrounding the
program. Clinics that specialize in treating newcomers as well as free medical clinics are being inundated with patient requests that are far outstripping their capacity to provide important health services.
There also continues to be great anxiety about the public release of the list of Designated Countries of Origin – which will greatly reduce coverage for some refugees including for heart attack patients and pregnant women and their babies.
“We want to work with the government to resolve this issue now – before there is a medical emergency we are unable to treat,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “It is time for the Minister to finally talk to the doctors treating refugees and meet with the major Canadian health organizations opposed to these cuts.”
Canadian Doctors for Refugee Care has recently submitted a proposal to Citizenship, Immigration and Multiculturalism Minister Jason Kenney that it believes offers a workable resolution to the issue while restoring necessary health coverage for refugees. The group will provide a public update as to the contents and status of this proposal in the near future.
The following is a new sampling of patient outcomes as reported by physicians:
· A teenager with Post Traumatic Stress Disorder and previous suicide attempts who has valid IFHP coverage is cut off from essential psychiatric medications
· A young girl from an area with malaria has a high fever but does not have health coverage to rule out malaria as she awaits her IFHP to be initiated
· A child with a potentially contagious rash is turned away from a clinic because her IFHP coverage, although valid, was not accepted by the clinic.
· A child with cough, fever and vomiting is only able to access care at a free clinic due to confusion around IFHP coverage
· Two children with severe asthma cannot get the medications they require to treat their illness due to delays in initiating IFHP coverage which have been occurring routinely since June 30, 2012
· A woman arrives in Canada pregnant but cannot get adequate testing to monitor her pregnancy as she awaits her IFHP coverage to be implemented
· A woman very late in her pregnancy is turned away by her regular doctor despite being eligible for IFHP coverage.
“This is about a vulnerable population not receiving access to health care,” said Dr. Rashid. “Our compassionate instincts as Canadians and the evidence points to the IFHP cuts being bad policy. Let’s fix this now.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / Chris_Holcroft@yahoo.com
Health care providers to rally in front of Conservative MP Kelly Block’s House of Commons office to protest offensive, misleading constituent flyer about federal government cuts to refugee health services
Health care workers from Ottawa and Saskatchewan are protesting an inflammatory and misleading constituent flyer from Conservative MP Kelly Block today. The health providers will be rallying in front of her House of Commons office at 730 La Promenade at 2 pm.
On Thursday October 11, constituents of Saskatoon-Rosetown-Biggar received a flyer out of MP Kelly Block’s office describing the cuts to the Interim Federal Health Program and stating that “new arrivals to Canada have received dental and vision care paid by your tax dollars. They’ve had free prescriptions. Not anymore.” Included in the flyer is a survey asking constituents to choose between two options: “I agree with Kelly Block! Newcomers don’t deserve more benefits than Canadians.” or “I disagree. Refugee claimants should get dental, vision and pharmacare even if I don’t.”
The health providers believe this flyer to be offensive and divisive, pitting Canadians against each other and against vulnerable populations in particular. Organizers also believe that the cuts to the Interim Federal Health Program will lead to poorer health outcomes for our society’s most vulnerable, increase health care costs and threaten public safety.
Who: Physicians, nurses, community health workers and many others from a number of different professional health disciplines
What: A rally to protest an offensive flyer sent by Conservative MP Kelly Block and cuts to refugee health care services
When: 2:00 PM Monday, October 22nd, 2012
Where: In front of MP Kelly Block’s office in Ottawa, 730 La Promenade, House of Commons.
Why: Reducing access to important health care services for refugees is an expensive public health risk and inconsistent with our values as a country, and so is pitting Canadians against each others and against vulnerable populations.
For more information or to arrange an interview please contact:
Mahli Brindamour
(306) 270-8739
mahli.brindamour@gmail.com
For immediate release
Canadian Doctors for Refugee Care releases update on impact of federal cuts to refugee health services
Toronto, September 27, 2012 – Three months after dramatic cuts to federally funded refugee health care services took effect, the program that manages these services is marred by confusion, unnecessary costs, and compromised care. These are the interim
findings from Canadian Doctors for Refugee Care, a non-partisan group of physicians with firsthand experience treating refugees in cities and towns across the country. The group has been documenting dozens of specific patient cases since the changes to the Interim Federal Health Program (IFHP) were announced June 30th.
“The IFH Program is in disarray and being mismanaged and the health of all refugees is being placed at risk,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “We advised the government from the beginning that these program cuts would reduce care, increase costs to other areas of the health system and needlessly threaten public safety, and regrettably, this is exactly what our colleagues are seeing in clinics and hospitals across Canada.”
Our reporting indicates a wide cross section of refugees being denied access to health care, with pregnant women and their babies being particularly impacted. Newly arrived refugees do not qualify for health care coverage for many weeks after making a claim. Many women are not receiving appropriate care for their pregnancy as a result. Six such cases have been seen at one small clinic alone in the last three months. The lengthy waiting period for coverage also affects refugees arriving from areas where they have been exposed to a myriad of health risks.
Another troubling finding is that many clinics and hospitals are refusing care to refugees because of a lack of clarity around IFH coverage rules and the inability of the government’s private sector insurance company, Blue Cross, to provide definitive information. In a separate survey of 30 walk-in clinics in the Toronto area, only five could clearly state they were accepting IFH coverage for refugees and understood the new rules.
While the decision by the federal government over the summer to reverse some of its planned cuts to the IFH Program lessened the severity of these cuts, there is still great uncertainty and anxiety about the changes to the IFH Program, particularly given that the list of Designated Countries of Origin – which will determine further reductions in coverage for some refugees – has yet to be publicly released.
“The government is telling some of the most vulnerable members of society they are not eligible for important, possibly life saving health coverage,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital.
In some parts of the country, provincial governments have stated they will pay for some health services that are being cut from the IFH Program. Yet provincial governments are also forced to pay for services that are being accessed – such as emergency room visits – as a last resort by refugees desperate for care and cut off from less expensive means such as primary care and
medications.
The following is a sampling of patient outcomes as reported by physicians across the country:
· A man requiring urgent eye surgery to prevent blindness is refused IFH coverage because he is said to be an “illegal migrant expected to leave the country”.Ten days later he receives notification from Citizen and Immigration Canada that he is eligible for permanent residency status.
· A young female refugee claimant is 18 weeks pregnant as a result of a sexual assault while being used as a sexual slave. She has no IFH coverage to address the pregnancy.
· A refugee claimant, 36 weeks pregnant, is told by her obstetrician that IFH will no longer provide insurance for her pregnancy or delivery and to bring in $3000 for her next appointment. After weeks of anxiety and investigation, the IFH program admits they made a mistake and the woman will be covered.
· A male refugee claimant experiencing chest pain and having characteristics that makes his physician suspicious of tuberculosis is not eligible for a chest x-ray.
· A female accepted refugee with asthma has an avoidable emergency room visit and hospitalization because of a lack of medication.
· A female refugee claimant with fibroids and adenomyosis has surgery cancelled due to her IFH status. As a result, the patient has numerous emergency room and doctor’s office visits for severe pain.
· A male refugee applicant will have his IFH coverage expire shortly. He has three children, two requiring immunizations and a third requiring follow-up on an operation on his aorta at birth. They were turned away from two clinics and unable to see a physician.
· A female refugee claimant who is a senior with diabetes and chronic kidney disease has her condition deteriorate because of lack of access to medication, regular blood testing and monitoring, and dietician education.
· A teenage refugee claimant has a high risk pregnancy, potentially life-threatening. She is still waiting on eligibility for renewed IFH coverage. In the interim she hopes to avoid unnecessary complications and hospitalizations.
· A refugee claimant who is a mother of two is told by Citizenship and Immigration officials that she would no longer be eligible for IFH coverage after June 30th unless it was an emergency. She has therefore been unable to seek treatment for high blood pressure.
· A refugee claimant, 32 weeks pregnant, presents at two emergency rooms suffering from lower abdominal pain. On both occasions she is told that she would have to sign a document stating that she would be responsible for the costs of her visit. She leaves the emergency room on both occasions without being seen.
· A man admitted to hospital with congestive heart failure and 12 other medical conditions is discharged home without the necessary home care follow up, placing him at a much higher risk of readmission.
Canadian Doctors for Refugee Care is renewing its call for the federal government to reconsider its changes to the IFH Program. At the very least, the group recommends the Standing Committee on Citizenship and Immigration conduct a thoughtful, thorough evaluation of the impact of the cuts to the IFH Program.
“Physicians will continue to track individual patient cases and report back on our findings,” said Dr. Rashid. “We are not going away until the government does the right thing and completely reverse these reckless health care cuts.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
One physician's perspective on cuts to IFH program
Dr. Paul Caulford runs a clinic in Scarborough for people without health insurance. He has noted a dramatic increase in people presenting to his clinic since the cuts to IFH took effect. For those that are interested he has begun to document some of his stories though a blog at http://refugeediaries.ca/.
Health Care Coverage Table for Refugee Claimants and Refugees in Ontario
Please see the following link for an overview of health care coverage for refugee claimants and refugees in Ontario since the changes to the Interim Federal Health Program. The table applies specifically to Ontario, as there are certain differences between provinces. Although all information has been carefully checked by experts in refugee law and health policy, they cannot guarantee accuracy or completeness.
http://health4all.ca/sites/health4all.ca/files/refugee%20health%20care_Ontario_Aug.2012.pdf
For immediate release:
Government backs down again on another aspect of refugee health cuts but many refugees still being denied
care
Toronto, July 26th, 2012-The Federal Government has quietly backed down on another element of its proposed cuts. When the cuts were announced in April, 2012, care for most refugees was to be confined to “urgent and essential care”. Government
documents stated that care would not be provided for issues such as birth control or hip replacements. Now, without announcement or explanation, the Citizenship and Immigration Canada website states that most refugee claimants and privately sponsored refugees will have health coverage similar to provincial health programs where such services are covered. This is an important step toward protecting refugee health, but the unannounced reversals in policy are sowing confusion amongst health care providers and refugees.
Despite this reversal, many refugees continue to be denied access to health care. In particular, newly arrived refugee claimants are now denied health insurance for up to six weeks after arrival. This has resulted in people not being able to access care even after arriving from areas where they have been exposed to a myriad of health risks.
“We have seen a number of cases where people have required assessments for potentially very serious conditions but they lack the insurance to obtain investigations or treatments,” said Dr. Meb Rashid of the Crossroads Clinic at Women’s College Hospital.
Dr. Rashid points to a case of a woman who arrived 18 weeks pregnant due to sexual violence she suffered while forcibly confined in her home country. “I was unable to provide the necessary care for her pregnancy; even obtaining an ultrasound became a challenge as she had absolutely no health insurance. This places refugees at great risk but also imposes a risk to refugee-receiving communities”.
Dr. Tim O’Shea of Hamilton expressed concern about the confusing new bureaucracy in place to administer the changes to refugee health insurance. “Physicians are asked to contact the administrator of the health insurance program to confirm eligibility before
each patient visit,”said Dr. Shea. “This is impossible in any busy office. Also, their offices close at 4:30 pm and when they are reached they often state they will call back in 24 to 48 hours. It is absurd. With all the reversals in the program and the complexity of how it is administered, we are hearing numerous cases of patients who are not seeking out care because they incorrectly believe they are not covered. We are also hearing stories of physicians who are unable to decipher who is covered and for what services. This roll out has been a nightmare and has unnecessarily put patients at risk.”
Dr. Megan Williams, from Somerset West Community Health Centre in Ottawa, is urging the federal government to abandon it s health cuts altogether. “We are asking the government to rescind the cuts to health insurance so that all refugee patients have access to the same health care services that are available to other low income Canadians,” said Dr. Williams. “It is becoming clear that the government acknowledges that these cuts are misguided and costly and is quietly reversing elements of their initial
policy. We would ask them to continue this reflection and to rescind the cuts in their entirety.”
Canadian Doctors for Refugee Care encourages the government to heed the warnings of the numerous national health care organizations such as the Canadian Medical Association that have asked the government to reverse these cuts. We are pleased by the second reversal of elements of the policy but demand that the government reverse all of the cuts and stop needlessly putting vulnerable communities at risk.
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For more information or to arrange an interview please contact:
Dr. Meb Rashid (Toronto) 416-315-1270 mebrashid@hotmail.com
Dr. Megan Williams (Ottawa) 613-816-0850 mwilliam@swchc.on.ca
Dr. Mark Tyndall (Ottawa) 613-979-3098 mtyndall@toh.on.ca
Tim O’Shea (Hamilton) 289-237-8597 toshea99@gmail.com
Dr. Mike Dillon (Winnipeg) 204-330-1703 mdillon@klinic.mb.ca
Dr. Robert Martin (Vancouver) 778-232 6939 cabbagesandkings1@gmail.com
Dear Canadian healthcare provider,
The purpose of Refugee Health Outcome Monitoring and Evaluation System (Refugee HOMES) is to monitor the effects of changes to the Interim Federal Health Program effective from 30 June 2012 on adverse health outcomes experienced by refugees in Canada. The online data submission from can be accessed at:
http://www.surveymonkey.com/s/66KPGVS
Ou, en français à:
http://www.surveymonkey.com/s/WD9DHMS
This adverse outcome monitoring system relies on accurate and timely information being provided voluntarily by you, the care provider. It is important to both quantify the impact of the changes in coverage and to share the stories of the people affected. Please promptly and without exaggeration or embellishment report all adverse outcomes suffered by refugees that are related to healthcare or medication access.
Details of the changes to the Interim Federal Health Program and the new classification system for refugees based on their country of origin can be found on the Citizenship and Immigration Canada website:
http://www.cic.gc.ca/english/refugees/outside/coverage.asp
Please complete one form for each independent adverse outcome. You may complete multiple forms for a single patient if the patient has suffered multiple independent adverse outcomes, or if the severity of an adverse outcome has changed significantly (e.g. complete a second form if a patient who was hospitalized for angina suffers a myocardial infarction). Do not complete multiple forms for the same adverse outcome.
The only mandatory field is the contact information of the care provider completing the form. This information may be used to verify the accuracy of information on this form or to obtain additional information about the adverse outcome but it will not be used for any other purpose.
Please do not include any information that would allow individual patients to be identified. Please indicate on the form if you, the patient or a representative of the patient are willing to publicly explain how the patient was affected by the changes to the Interim Federal Health Program.
Any potentially preventable deaths should be both reported using this form and promptly reported to the appropriate coroner or medical examiner.
We will periodically publicize summaries of the adverse outcome data collected across Canada. We will also make periodic updates to this data collection form and we welcome your feedback.
Please notify your colleagues of this important monitoring system by, for example, circulating this letter. Thank you very much for your diligence.
Sincerely,
Refugee HOMES Team
For immediate release
Canadian Doctors for Refugee Care unveil plan to monitor consequences of federal cuts to refugee health services
Ottawa, June 27, 2012 –With the clock about to strike midnight on refugee access to important health care services, Canadian Doctors for Refugee Care are making a final plea to the federal government to save these services from pending cuts to the Interim Federal Health Program. The group is also unveiling a plan to monitor the health consequences of these cuts, set to take effect June 30th.
“The federal government still has time to reverse these irrational and inhumane health care cuts,” said Dr. Mark Tyndall, Professor of Medicine, University of Ottawa and Chief of infectious diseases, The Ottawa hospital.. “At the very least, we call on Minister Kenney to suspend these cuts and conduct a true consultation with health professionals who, en masse, have warned of the potentially devastating impact of these cuts on public health and safety.”
Canadian Doctors for Refugee Care is part of broad coalition of national associations and grassroots health providers deeply concerned that the federal cuts to refugee health services will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety. For example, many refugees accepted to, and living in, Canada will no longer qualify for coverage for necessary medications such as insulin. Some refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all categories of refugees are: prenatal care for pregnant women, well child care and even care for heart attacks and
some other medical emergencies.
On June 18th, Canadian Doctors for Refugee Care helped organize demonstrations in 14 cities across the country that were attended by more than 2,000 health providers. This unprecedented level of solidarity within the health care community has prompted a commitment from physicians across the country to participate in a program designed to track the consequences of the health cuts on refugees.
“We are not giving up,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital in Toronto. “If the government will not track the consequences of these changes physicians will. Perhaps when the government sees, quite literally, the devastating and lethal impact of these cuts it will do the right thing and restore basic health coverage to all refugees.”
Canadian Doctors for Refugee Care will have in place by June 30th a nation-wide surveillance system that will have the capacity to track and analyze instances of adverse health outcomes on refugees as a result of the changes to the Interim Federal Health Program. This network of physicians across Canada will be reporting the details of any such cases in to a centralized data collection system. The group will then collate and report these stories back to Members of Parliament, the media, and the general public
on a regular basis. Physicians are also contacting their respective provincial coroners to alert them to the changes.
“I stand before you today as living evidence of the Canadian dream – a dream built on dignity, opportunity and compassion,” said Dr. Parisa Rezaiefar, a refugee who came to Canada and is now a family physician at the Bruyere Academic Family Medicine
Centre, a lecturer at the University of Ottawa and emergency room physician at the Children Hospital's of Eastern Ontario. “I urge Minister Kenney to not take away that dream from today’s refugees and tomorrow’s citizens. The Interim Federal Health Program is not charity; it is an investment in the future of the country.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
Media Advisory
Canadian Doctors for Refugee Care to unveil plan to monitor consequences of federal cuts
to refugee health services
Canadian Doctors for Refugee Care, a group of grassroots physicians who have been working with other health care workers opposed to changes to the Interim Federal Health Program will be holding a press conference to make a final plea to the government to protect vital health services for refugees. The physicians will also unveil a national plan to monitor and publicly report on the health consequences of federal cuts to this program.
Doctors and other health care workers are deeply concerned that the cuts, set to come into effect June 30, will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety. On June 18th, Canadian Doctors for Refugee Care helped organize demonstrations in 14 cities across the country that were attended by more than 2,000 health providers. More than a dozen national health care associations are also opposed to these changes. This is an unprecedented show of solidarity
among the health care community.
Who: Members of Canadian Doctors for Refugee Care
- Dr. Parisa Rezaiefar, Family Physician, Bruyere Academic Family Medicine Centre
- Dr. Mark Tyndall, Chief of Infectious Diseases, The Ottawa Hospital and the University of Ottawa
- Dr. Philip Berger – Chief of Family and Community Medicine, St. Michael’s Hospital
What: Press conference to outline next steps in groups’campaign against cuts to refugee health care
Where: The Charles-Lynch Press Conference Room, Centre Block of Parliament, Ottawa
When: Wednesday, June, 27th at 11:00 a.m. EST
Why: The federal cuts are likely to have devastating consequences for the health of refugees, are an expensive public health risk, and are inconsistent with Canadian values
More information can also be found on our website at www.doctorsforrefugeecare.ca.
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For more information please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
chris_holcroft@yahoo.com
The Department of Psychiatry at the University of Toronto expresses concerns about changes to refugee health coverage:
http://www.utpsychiatry.ca/bill-c31-uoft-psychiatry-position-statement/
Amnesty International expresses concerns about changes to refugee health coverage:
http://www.amnesty.ca/media2010.php?DocID=1617
The Public Health Association of British Columbia releases its position on changes to refugee health care:
http://phabc.org/userfiles/file/PHABCPositiononChangestoHealthCareCoverageforRefugees(1).pdf
The Ontario Medical Association voices concerns about planned changed to the IFH
Program: http://www.newswire.ca/en/story/994261/refugee-health-changes-a-concern-ontario-doctors
Response to the Interim Federal Health Program Cuts and Bill C31 by Health Professionals of McGill University Department of Psychiatry - http://www.mcgill.ca/psychiatry/sites/mcgill.ca.psychiatry/files/bill_c31_mcgill_en.pdf
For immediate release
Health care workers to hold National Day of Action June 18th to protest planned federal government cuts to refugee health services
Unprecedented events being organized in 10 cities across the country
Toronto, June 12, 2012 –Health care workers united in opposition to planned reductions in health care coverage for refugees are holding a national day of action in hopes of persuading the federal government to reverse course. Physicians, nurses, community health workers and many others from a number of different professional health disciplines will be participating in demonstrations in 10 cities from coast to coast on Monday, June 18th. The health care workers are deeply concerned that the changes to the Interim Federal Health Program (IFHP) scheduled to take effect June 30, 2012 will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety.
“Many health care workers, especially in urban areas throughout Canada, treat refugees on a daily basis,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We listen to their stories of enduring war and violence and being separated from their families. We believe it is inhumane to deny them access to the health care they need to begin their new lives in Canada. This is at the heart of why we are demonstrating on June 18th.
The federal government recently announced plans to cut important health care services for refugees as of June 30, 2012. For example, many refugees accepted to, and living in, Canada will no longer qualify for coverage for necessary medications such as insulin. Some refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all refugees are: prenatal care for pregnant women, well child care and access to mental health care.
Health care workers will also be using the demonstrations as an opportunity to clarify some of the facts over the planned IFHP changes, such as:
· There will not be cost savings. Restricting access to preventive care leads to repeated emergency room visits and hospitalizations that increase costs to the health system.
· The risks to public safety will be greater. Most patients only pose a public health risk if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they become very sick, they will likely have already infected others.
· These changes do not bring fairness to the health system. Refugees do not currently receive better health care than other Canadians. In fact, IFHP coverage does not provide broader insurance than what is available to another vulnerable population, low-income Canadians.
· We need not fear refugees abusing the health system. Engaging vulnerable populations in preventative and primary care is challenging enough as it is, and access to a high standard of health care would be a low priority for refugees who are used to struggling just to survive.
“We encourage the federal government to listen to reason and act with compassion,” said Dr. Gary Bloch, a family physician with St. Michael's Hospital. “Maintaining a healthy community means ensuring all members of the community – including refugees – receive basic, medically necessary care. This is the Canadian way.”
Schedule of events
· Toronto – 1 pm -demonstration outside the Citizenship and Immigration Canada office at 25
St. Clair Avenue East
· Hamilton – 1 pm -demonstration outside the Citizenship and Immigration Canada office at 55 Bay Street
North
· Ottawa - Noon –demonstration on Parliament Hill
Montreal - 12:30 pm – demonstration outside the Citizenship and Immigration Canada office at 1010 St. Antoine Ouest
· St. John's - There will be a press conference held, details TBC, please check www.doctorsforrefugeecare.ca
for updates
· Winnipeg - Noon –Demonstration at the Forks Plaza
· Saskatoon - Noon –Demonstration and parade at Kiwanis Memorial Park
· Calgary - Noon –Demonstration at Harry Hays Building at 220 4th Ave SE
· Edmonton – Demonstration to be held, details TBC, please check www.doctorsforrefugeecare.ca for
updates
· Vancouver - Noon –demonstration outside the Citizenship and Immigration Canada office at 1148 Hornby Street
Among the health care organizations supporting the national day of action on June 18th:
Canadian Doctors for Refugee Care * College of Family Physicians of Canada * Royal College of Physicians and Surgeons of Canada * Canadian Association of Optometrists * Canadian Association of Social Workers *
Canadian Dental Association * Canadian Medical Association * Canadian Nurses Association * Canadian Pharmacists Association * Canadian Association of Community Health Centres * Canadian Association of Midwives * Canadian Paediatric Society * Canadian Psychiatric Association * Association of Medical Microbiology and Infectious Diseases Canada * Canadian Federation of Medical Students
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
The Department of Family and Community Medicine, University of Toronto, released the following position statement about the planned IFH program changes:
http://www.dfcm.utoronto.ca/about/newsevents/news/060612-1.htm
The Canadian Psychiatric Association adds their voice to the growing concerns about planned health care cuts for refugees in this letter to Minister Kenney: http://www.cpa-apc.org/media.php?mid=1742
The Canadian Paediatric Society warns cuts to refugee health program will put children & youth at risk:
http://www.cps.ca/English/advocacy/CPS_RefugeeHealth.pdf
Candians Doctors for Refugee Care released an open letter it sent to Canada's Provincial Ministers of Health today - please read the text of the letter below.
Open letter to Provincial and Territorial Health Ministers from Canadian Doctors for Refugee Care
June 5, 2012
Dear Minister:
We are writing to alert you to an issue that will threaten public health in your province, divert precious provincial health care dollars and likely challenge federal-provincial relations.
The federal government recently announced plans to cut important health care services for refugees as of June 30, 2012 with sweeping changes to the Interim Federal Health (IFH) program. Refugees living in Canada will no longer be able to access care unless it is deemed urgent or essential. What is urgent or essential has not yet been defined but it is clear preventative care will no longer be covered. In addition, all refugees will lose access to medications such as insulin and emergency dental and vision care. Depending on their country of origin, refugee claimants will be denied access to physicians all together unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all refugees are: prenatal care for pregnant women, well child care and access to mental health care.
On May 11, physicians in cities across the country, many of whom treat refugees on a daily basis, organized demonstrations, press conferences and public events to protest these changes. Following an overwhelming positive response from the medical community and public at large, these physicians have come together to launch Canadian Doctors for Refugee Care.
We are deeply concerned that denying refugees access to preventative care, key medications and diagnostic exams will:
• Risk outbreaks of public health threats such as tuberculosis
• Force provincial governments to address refugee health care via expensive acute and critical care services instead of primary care resources paid for by a federal government program
• Strain federal-provincial relations as the provinces will take on, de facto, refugee health as part of
growing citizenship and immigration responsibilities without an agreement or appropriate compensation
We are calling on all provincial and territorial governments to stand with us and oppose these changes on the grounds that they are poor public health policy, create unnecessary burdens on local health systems - especially in urban centres and provincial capitals – and represent unjust treatment of refugees residing in this country, some of whom will have just escaped war, violence or famine.
On Monday, June 18 in cities across the country physicians and others opposed to cutting health services for refugees will be participating in a day of action. We hope that you will join us in this critical fight by advocating for the federal government to reverse its planned changes to the IFH program. We further hope that you will impress upon your federal counterparts the importance of Canada remaining a global leader in international justice, humanitarianism, and protectors of public health around the globe.
We would be pleased to provide you with further information or arrange to speak with you about this issue in greater detail. Please contact Christopher Holcroft at 416-996-0767 or chris_holcroft@yahoo.com if we can be of
assistance.
Sincerely,
Dr. Philip Berger
Dr. Gary Bloch
Dr. Jane Pritchard
On behalf of Canadian Doctors for Refugee Care
cc: Canada’s Provincial Ministers of Health
Canada’s Provincial Ministers of Citizenship and Immigration
Toronto Board of Health endorses formal position against the planned IFH cuts
http://www.toronto.ca/legdocs/mmis/2012/hl/bgrd/backgroundfile-47324.pdf
The Wellseley Institute released an equity analysis of the planned IFH cuts
http://www.wellesleyinstitute.com/health-care/toronto-board-of-health-sees-the-real-cost-of-cutting-refugee-health-benefits/
May 18 letter to Minister Kenney from national medical groups
Eight prominent national health care groups have written Minister Jason Kenney to register their opposition to planned federal cuts to health services for refugees, including:
Canadian Association of Optometrists
The Canadian Medical Association
The Canadian Nurses Association
The Canadian Association of Social Workers
The Canadian Dental Association
The Canadian Pharmacists Association
The College of Family Physicians of Canada
The Royal College of Physicians and Surgeons of Canada
You can read their letter here: http://www.pharmacists.ca/cpha-ca/assets/File/cpha-on-the-issues/SuppBenefitsKenneyEN.pdf
Press release from May 11th demonstration
May 11, 2012
For immediate release
More than eighty physicians descend on federal Minister’s office to protest planned cuts to health coverage for refugees
Toronto, ON – More than eighty physicians, many of them prominent members of the medical community representing a broad range of disciplines, have descended upon Conservative Minister Joe Oliver’s constituency office this hour as part of a national, grassroots effort to protect the modest health services currently provided to refugees. The physicians – some of whom intend to sit in silence inside the office while others rally public support outside – are seeking an emergency meeting with the Minister (the highest ranking member of the federal government in Toronto) to discuss planned changes to the Interim Federal Health Program scheduled to take effect June 30, 2012.
“Eliminating critical elements of health coverage for refugees is not only callous, it is poor health policy,” said Dr. Philip Berger, head of family medicine at St. Michael’s Hospital. “Maintaining a healthy community means ensuring all members of the community – including refugees – receive basic, medically necessary care. This is the Canadian way.”
Under the changes announced by the federal government on April 25th, refugees accepted to, and living in, Canada will no longer qualify for necessary medications such as insulin. A number of refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. In addition, there will be no coverage provided for addressing issues such as prevention of tuberculosis and well child care.
“Many doctors, especially in urban areas throughout Canada, treat refugees on a daily basis,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We listen to their stories of enduring war and violence and being separated from their families. We believe it is inhumane to deny them access to the health care they need to begin their new lives in Canada.
Part of the rationale for the public action by physicians is to challenge the arguments being advanced by the government to explain the decision. Consider:
· There will not be cost savings. Restricting access to preventive care leads to repeated emergency room visits and hospitalizations that increase costs
to the health system.
· The risks to public safety will be greater. Most patients only pose a public health risk if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they are coughing up blood, they will likely have already infected others.
· We need not fear refugees abusing the health system. Engaging vulnerable populations in preventative and primary care is challenging enough as it is, and access to a high standard of health care would be a low priority for refugees who are used to struggling just to survive.
“We are extremely frustrated with the misinformation on this issue,” said Dr. Jane Pritchard, a family physician who works with refugees. “We do not see refugees requiring health care as a public drain on the system, instead we see future citizens protecting and improving their health as an investment that benefits the entire community.”
“We encourage the federal government to listen to reason and act with compassion,”said Dr. Gary Bloch, a family physician with St. Michael's Hospital. “If we want healthy, prosperous communities, refugees need medical treatment too.”
Minister Oliver’s constituency office is located at 511 Lawrence Avenue West, just west of Bathurst Street in Toronto.
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Mayy 11th letter to Minister Joe Oliver from Toronto physicians opposed to cuts in health care services for refugees
May 11, 2012
Hon. Joe Oliver
Minister of Natural Resources
Member of Parliament for Eglinton-Lawrence
511 Lawrence Avenue West
Toronto, ON M6A 1A3
Re: Meeting request to discuss planned changes to Interim Federal Health Program
Dear Minister,
We are writing to you on behalf of more than 80 physicians in the Toronto area who are deeply troubled by your government’s planned changes to the Interim Federal Health Program, scheduled to take effect June 30, 2012. As experienced doctors who see refugees as patients on a regular basis, it is our professional opinion that these changes will worsen health outcomes for refugees, put the health of the broader public at risk and lead to increased costs to the health system.
As you know Canada has a long and proud history of providing refuge to men and women around the world who are fleeing war, famine, political persecution, torture or violence. Part of that refuge includes providing individuals with basic health services. This is not only the compassionate act of a privileged country but it is also sound public health policy.
The planned changes will eliminate or restrict a wide range of important health services for refugees depending on their claimant status and Designated Country of Origin. Included among the health care services to be cut that will impact some or all refugees are: prenatal care for pregnant women, insulin for diabetic children and access to mental health services.
Restricting access to preventive care however leads to repeated emergency room visits and hospitalizations that increase costs to the health system. Reducing primary health care access also poses public health risks. For example, if a person with tuberculosis is only offered care after they are coughing up blood, they will likely have already infected others.
We believe the objectives of our group, and those of the government, namely a fair, just and affordable health care system, are aligned. We are therefore confident that a review of the facts of this issue will convince your government not to proceed with the planned changes to the Interim Federal Health Program. After all, protecting and improving the health of refugees – many of whom will become citizens one day – is an investment that benefits the entire community.
Given that these changes are scheduled to take effect in a few weeks, we are respectfully asking for a meeting at your earliest opportunity. Please have your office advise Dr. Philip Berger at 416-802-1191 when you are available for this meeting. Thank you in advance for your consideration of this request.
Sincerely,
Dr. Philip Berger
Dr. Gary Bloch
Dr. Jane Pritchard
Dr. Jesse McLaren
Dr. Meb Rashid
Cc: Hon. Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism
Right Hon. Stephen Harper, Prime Minister
Over 50 Prominent Canadian writers and artists sign declaration calling on federal government to reverse refugee health cuts
Dr. Vincent Lam, Adrienne Clarkson, and Kiefer Sutherland among those pledging support on eve of 2nd National Day of Action
Toronto, June 13, 2013 – The campaign for refugee health care gained some high profile new support today as dozens of prominent Canadian writers were joined by actors, filmmakers, and musicians in signing a declaration which calls on the federal government to reverse its cuts to the Interim Federal Health Program. It has been almost one year since the government made changes to the program which has left many patients – including sick children and pregnant women fleeing sexual violence – suffering.
“As a physician, and as a Canadian, it is unacceptable to me that refugees in need of health services are being denied care,” said award winning author Dr. Vincent Lam. “I stand proudly with my colleagues in the medical and arts communities in calling on the federal government to reverse these harmful cuts.”
Among other signatories to the declaration, Speaking up for Canada – Opposing cuts to health services for refugees, are authors Margaret Atwood, Yann Martel, and Rohinton Mistry, actors Shirley Douglas and Kiefer Sutherland, musician Jian Ghomeshi, and former Governor General Adrienne Clarkson and her husband, writer John Ralston Saul.
As the declaration notes, “refugees arriving in Canada – many of whom are fleeing war, violence, or famine – often come with little more than the clothes they are wearing. Access to basic health services is guaranteed to them under the Charter; care has been provided because it is the right thing to do.”
A National Day of Action is being planned in 19 cities across Canada on Monday, June 17th. Dr. Lam will be speaking at the event in Toronto. Please visit http://www.doctorsforrefugeecare.ca/day-of-action-june-17-2013.html for detailed information.
“This campaign began with a few physicians expressing alarm over the health impacts of federal cuts to refugee care,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “As a result of the government’s continued intransigence and mendacity, the campaign has attracted a diverse coalition of Canadians who believe there is no place for these reckless cuts in a fair and generous society.”
The declaration and a complete list of signatories follow.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal, Empower Consulting
416-996-0767
Christopherholcroft@hotmail.ca
Speaking up for Canada – Opposing cuts to health services for refugees
Canada has a proud humanitarian tradition.
We offer refuge to those seeking safety, rights to those seeking justice, and care to those who are ill. Yet these principles which define us are being undermined by a policy change that is delivering real harm to a vulnerable
population.
On June 30th, 2012, the federal government made cuts to the Interim Federal Health Program that have resulted in important health services for refugees being eliminated or restricted.
Refugees arriving in Canada – many of whom are fleeing war, violence, or famine – often come with little more than the clothes they are wearing. Access to basic health services is guaranteed to them under the Charter; care has been provided because it is the right thing to do.
Now, due to these cuts, many refugees – future citizens of this country – are being denied services, including children and pregnant women. The non-profit organization Canadian Doctors for Refugee Care has documented many such unacceptable cases on their website. The federal cuts have also sown confusion within our health system, further restricting access to care for
refugees and resulting in unnecessary costs being borne by provincial governments.
This is not the Canadian way.
We call on the federal government to reverse these health cuts and restore our country’s humanitarian tradition of providing care to refugees.
On June 17th, please join us and Canadian Doctors for Refugee Care in participating in a National Day of Action. There are events taking place in cities across the country. To learn more, please visit www.doctorsforrefugeecare.ca.
Signatures
Stephen Andrews
Sara Angel
Margaret Atwood
Jack Batten
John Bemrose
Randy Boyagoda
Joseph Boyden
Cathy Marie Buchanan
Stevie Cameron
Wayson Choy
Adrienne Clarkson
Karen Connelly
Erika de Vasconcelos
Shirley Douglas
Sarah Elton
Will Ferguson
Ken Finkleman
Charlie Foran
Richard Fung
Jian Ghomeshi
Camilla Gibb
Don Gillmor
Lee Gowan
Charlotte Gray
John Greyson
Rawi Hage
Marjorie Harris
Lawrence Hill
Miranda Hill
Naomi Klein
Vincent Lam
Michele Landsberg
Kyo Maclear
Yann Martel
Ashok Mathur
Ken McGoogan
Rohinton Mistry
Michael Ondaatje
Katrina Onstad
Ian Iqbal Rashid
Nino Ricci
Robert Rotenberg
Kerri Sakamoto
John Ralston Saul
Emily Schultz
Philip Slayton
Linda Spalding
Kiefer Sutherland
Madeleine Thien
Miriam Toews
Jane Urquhart
For immediate release
Health care workers in 17 cities across Canada to call for restoration of refugee health services as part of second National Day of Action June 17th
Toronto, June 10, 2013 – Canadian Doctors for Refugee Care is holding a second National Day of Action on June
17th to call on the federal government to reverse the reckless cuts to refugee health care. It has been almost one year since the government made changes to the Interim Federal Health Program (IFHP) which has left many patients – including sick children and pregnant women fleeing sexual violence – suffering. Due to overwhelming interest, events will be happening in at least 17 cities across the country. These events are a demonstration of health care workers and allies’ unwavering support of refugee patients and ongoing opposition to the IFH cuts.
“Our message to the federal government is clear – we are not going away,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “This year even more cities are participating and we will continue our campaign against these punishing and costly cuts.”
Canadian Doctors for Refugee Care has documented many cases of people being denied care including pregnant women and sick children. Eight months ago, the group submitted a written proposal to Citizenship, Immigration, and Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The group has yet to receive any response to its proposal.
This year’s events are being guided by a new generation of health care workers, as medical residents and students are taking the lead in organizing in many cities. In fact, in an unprecedented move, two universities – McGill and the University of Toronto – are facilitating learner participation in the National Day of Action.
“We are trained to treat people based on their disease, not their country of birth or refugee category,” said Dr. Vanessa Redditt, family medicine resident, University of Toronto. “The government should not be asking us to deny care to those who need it.
This is ethically unacceptable and has devastating health consequences. We will continue to provide care to these patients and, as importantly, to advocate on their behalf.”
“These young doctors will see the tragic consequences of this policy change over and over through the course of their careers unless the federal government reverses course,” said Meb Rashid, medical director of the Crossroads Clinic at Women's College
Hospital.
Over 20 health care organizations continue to support this campaign. Physicians, nurses, community health workers and many others from different professional health disciplines will be joining students and other Canadians participating in
demonstrations on Monday, June 17th.
Please see a list below of participating cities and visit http://www.doctorsforrefugeecare.ca/day-of-action-june-17-2013.html for further updates on these and additional events:
- Victoria - 4pm; South East corner of Douglas Street and Fort Street - contact: Victoria4refugeehc@gmail.com
- Vancouver - Noon; in front of the regional Citizenship and Immigration office, 1148 Hornby Street - contact:
vancouver4refugeecare@gmail.com
- Calgary - 10am; press conference in the Eau Claire Market Community Space - contact: juliabietz@yahoo.ca
- Edmonton - Noon; in front of the Alberta Legislature - contacts: dallasdyson@hotmail.com or bamohame@ualberta.ca
- Saskatoon - Noon; gathering at the bandshell in Kiwanis Park, then marching across the University Bridge to the Royal
University Hospital - contact: saskrefugeehc@gmail.com
- Winnipeg – Noon; public press conference in Central Park, near the fountain – contact: mdillon@mts.net
- Thunder Bay - Details TBC - Contact: obabalola@nosm.ca
- Sudbury - Details TBC - Contact: obabalola@nosm.ca
- Windsor - Details TBC
- Kitchener - Noon; in front of Kitchener City Hall - 200 King Street West - contact: kwrefugeehc@gmail.com
- Hamilton - 1:00 pm; in front of the regional Citizenship and Immigration office, 55 Bay Street North - contact:
hamiltonnoifhcuts@gmail.com
- Toronto - Noon; in front of the Canadian Citizenship and Immigration office, 25 St. Clair Avenue East - contact: docs4refugeehc@gmail.com
- Kingston - Noon; meet beside the water fountain at the corner of King Street and Market Street in Springer Market Square - contact: cbrace@qmed.ca
- Ottawa - Noon; on Parliament Hill - contact: ottrefugeehc@gmail.com
- Montreal - Noon; at Complex Guy-Favreau - contact: Helen Hsu at kanneikyo@gmail.com
- Halifax - 12:30 pm. at the Grand Parade - contact: halifaxrefugeeclinic@gmail.com
- St. John's - Details TBC
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
MCGILL BECOMES SECOND UNIVERSITY TO FACILITATE LEARNER PARTICIPATION IN NATIONAL DAY OF ACTION
Please see e-mail sent to students of McGill from Associate Dean below.
Dear Students –
The Canadian Doctors for Refugee Care (CDRC) is organizing a second National Day of Action on Monday June 17, 2013 to protest
the refugee health care cuts, which now includes 13 cities. Much of the preparation in Montreal is being led by residents and medical students. The Montreal protest will be held at Complex Guy-Favreau, from 12h00 – 14h00. McGill University cannot take political positions on this or other matters. However, students are taught to be advocates for their patients and this is an excellent opportunity to do so. At the students’ request, I permit you to attend the National Day of Action. Please advise your supervisors if you would like to attend. The Faculty will send out a notification to facilitate this. You will be relieved for a short time from your
usual responsibilities from 11h30 – 14h30 for travel to and from the event.
For the Class of 2016: You have a case conference scheduled at 14h35. You are expected to be back for this. Toby will arrange for the case to be released earlier in the day than usual to allow you time to complete it. More information on the CDRC
is listed at the end of this communication.
Robert Primavesi, MDCM, FCFP(EM)
Associate Dean
Undergraduate Medical Education and Student Affairs
Faculty of Medicine, McGill University
3655 Promenade Sir William
Osler Montréal, QC, Canada H3G 1Y6
CDRC:
Canadian Doctors for Refugee Care is an incorporated group of non-partisan physicians from across Canada , most of who treat refugees. CDRC was established in the spring of 2012 as an advocacy group singularly focused on persuading the federal government to rescind severe cuts to health care coverage for refugee claimants under the Interim Federal Health program. CDRCis also a co-litigant in a Charter challenge to the cuts. Prior to the cuts which took effect June 30, 2012 and
since 1957, IFH provided insurance coverage to refugee claimants for the full breadth of health services and medications and equivalent to that received by people on welfare. CDRCseeks to reverse the cuts or change them so that basic health benefits are restored to refugee claimants.
Organizations opposing cuts to refugee health care:
i. College of Family Physicians of Canada
ii. Royal College of Physicians and Surgeons of Canada
iii. Canadian Association of Optometrists
iv. Canadian Association of Social Workers
v. Canadian Dental Association
vi. Canadian Medical Association
vii. Canadian Nurses Association
viii. Canadian Pharmacists Association
ix. Canadian Association of Community Health Centres
x. Canadian Doctors for Medicare
xi. Canadian Association of Midwives
xii. Registered Nurses Association of Ontario
xiii. Canadian Federation of Nurses Union
xiv. Canadian Psychiatric Association
xv. Canadian Paediatric Society
xvi. Association of Medical Microbiology and Infectious Diseases Canada
xvii. Médecins du Monde
xviii. Public Physicians of Canada
xix. Ontario’s Council of Medical Officers of Health
xx. Canadian Association of Occupational Therapists
xxi. Canadian Association of Emergency Physicians
UNIVERSITY OF TORONTO FACULTY OF MEDICINE FACILITATES LEARNER PARTICIPATION IN NATIONAL DAY OF ACTION
The memo below was signed by the Vice Dean Post Graduate Medical Education and an identical memo was signed by the Vice Dean Under Graduate Medical Education, Faculty of Medicine , University of Toronto.
The Faculty's memo should serve as an exemplar for faculties of medicine across Canada and is a bona fide expression by the Academy of support for learners who choose to engage in the CanMEDS role of physician as Advocate. Please distribute widely to Deans and Vice Deans of Faculties of Medicine and other health discipline faculties and to student/ resident associations.
This is an unprecedented and welcome move by the university.
________________________________________________________________________________________
Dear Colleagues
I am writing to ensure you are aware of the following information regarding refugee health care.
The Canadian Doctors for Refugee Care is organizing a second National Day of Action on Monday June 17, 2013 to protest the refugee health care cuts, which now includes 13 cities. The Toronto protest will be held at 12 noon ( for 1 hour) at the Citizenship and Immigration Canada building, 25 St. Clair East near Yonge. Much of the preparation in Toronto is being led by residents and medical students at University of Toronto, with the support of faculty.
You will know of course that the University of Toronto cannot take political positions on this or other matters. However,
it is important that our Departmental and Education leads are aware that this event is taking place.
Regarding the participation of our learners, we would like to respectfully request the following: If a learner requests permission to attend the National Day of Action, we would ask you to facilitate this where possible. Please advise your faculty and supervisors that there may be learners in UGME and PGME who would like to attend, and that we should facilitate this. Our learners will need to be free (11:30 AM- 2:00 PM) and be relieved for a short time from their usual responsibilities for travel to and
from the event. (Please allow appropriate travel time based on the site of rotation.)
More information is listed at the end of this communication.
If you need further information regarding this National Day of Action please contact:
Philip B. Berger, MD
Chief, Department of Family & Community Medicine
Medical Director, Inner City Health Program
Associate Professor, University of Toronto
St. Michael's Hospital
30 Bond Street
Toronto, ON M5B 1W8
Phone: (416) 867-3712
Fax: (416) 867-3739
E-Mail: bergerp@smh.ca
CDRC:
*Canadian Doctors for Refugee Care is an incorporated group of non- partisan physicians from across Canada , most of who treat refugees. CDRC was established in the spring of 2012 as an advocacy group singularly focused on persuading the federal government to rescind severe cuts to health care coverage for refugee claimants under the Interim Federal Health program. CDRC is also a co-litigant in a Charter challenge to the cuts.
*Prior to the cuts which took effect June 30, 2012 and since 1957, IFH provided insurance coverage to refugee claimants for the full breadth of health services and medications and equivalent to that received by people on welfare. CDRC seeks to reverse the cuts or change them so that basic health benefits are restored to refugee claimants.
*Refugee claimants , many who will become Canadian citizens, are being denied necessary health services including prenatal care, acute and follow up care for medical emergencies such as heart attacks and routine preventive services. Since June 30, 2012 CDRC has independently verified over 50 cases of claimants being denied services including for example an epidural for a woman in labour, an ultrasound for a woman with fibroids and heavy vaginal bleeding and chemotherapy for cancer patients. Denial of services will cost more by allowing treatable conditions to progress, leads to more and preventable emergency department visits and places doctors in the position of having to treat patients on the basis of their legal status and country of birth, rather than medical need. As a simple matter of fairness to refugee claimants - many who have fled horrendous conditions , have neglected their health and are legally within our borders-health care should be provided to this needy and vulnerable group.
* CDRC will advocate for refugee health care coverage over the next 30 months until the next federal election.
* CDRC will continue to conduct its advocacy activities across Canada at public meetings, in meetings with legislators, at medical conferences, on university campuses, in hospitals /community clinics and at demonstrations.
* CDRC will continue to: document cases of refugees being denied services, hold meetings with interested legislators, educate the public and health discipline students about the effects of the cuts, write articles in medical journals and opinion pieces in the lay press, organize protests against the cuts, engage the media ( CDRC members have been interviewed hundreds of times and is largely responsible for the high profile of this issue) , assist postgraduate university students who are studying the issue, participate as speakers on panels and other educational events, inform colleagues about how the new IFH system works, field regular calls from health professionals across Canada about individual cases of hardship resulting from the cuts, secure services pro bono where CDRC is able, work with other refugee/immigrant organizations on this issue, advise over 20 national health associations who oppose the cuts, seek the assistance of faith based groups--all with the sole purpose of restoring health coverage to refugee claimants.
Organizations opposing cuts to refugee health care:
i.College of Family Physicians of Canada
ii.Royal College of Physicians and Surgeons of Canada
iii.Canadian Association of Optometrists
iv.Canadian Association of Social Workers
v.Canadian Dental Association
vi.Canadian Medical Association
vii.Canadian Nurses Association
viii.Canadian Pharmacists Association
ix.Canadian Association of Community Health Centres
x.Canadian Doctors for Medicare
xi.Canadian Association of Midwives
xii.Registered Nurses Association of Ontario
xiii.Canadian Federation of Nurses Union
xiv.Canadian Psychiatric Association
xv.Canadian Paediatric Society
xvi.Association of Medical Microbiology and Infectious Diseases Canada
xvii.Médecins du Monde
xviii.Public Physicians of Canada
xix.Ontario’s Council of Medical Officers of Health
xx.Canadian Association of Occupational Therapists
xxi.Canadian Association of Emergency Physicians
Sincerely,
Salvatore M. Spadafora, MD, FRCPC, MHPE
Vice Dean
Post Graduate Medical Education
Faculty of Medicine, University of Toronto
Room 602, 500 University Ave.
Toronto ON M5G 1V7
For immediate release
Canadian Doctors for Refugee Care says Interim Federal Health Program in crisis on Refugee Rights Day
Group plans second National Day of Action June 17th to take message to the streets
Toronto, April 4, 2013 –Canadian Doctors for Refugee Care is marking Refugee Rights Day by releasing more examples of refugees being denied necessary health care because of federal cuts and confusion surrounding the Interim Federal Health Program (IFHP). These are new cases reported since Canadian Doctors for Refugee Care joined with the Canadian Association of Refugee Lawyers to launch a Charter challenge to the federal government’s cuts to refugee health care.
As hospitals, community clinics, medical professionals, and provincial governments continue to struggle with the incomprehensible structure of the revised IFH program individual patients – including sick children and pregnant women fleeing
sexual violence – are suffering. This includes the recently publicized case of a Calgary woman who was denied cancer treatment.
“We are finding more and more patients legally here having to go without badly needed health care services,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College Hospital. “The patients we see have fled unimaginable terror to seek a safer life in Canada, and our government is telling doctors that they cannot provide necessary treatment.”
It has been six months since Canadian Doctors for Refugee Care submitted a written proposal to Citizenship, Immigration, and
Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The group has yet to receive any response to its proposal.
Canadian Doctors for Refugee Care is organizing a National Day of Action for June 17th to take the facts directly to the streets and tell Canadians the consequences of the federal government’s cuts to refugee health care.
“The Conservative government is failing many sick refugee children and women,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “These refugee families are legally within our borders and the government has a Charter responsibility to provide them with basic health care coverage. Life saving medication and prenatal care is not gold plated
health care. The government should finally start telling the truth.”
The following is a sample of cases catalogued by Canadian Doctors for Refugee Care in which refugees have been refused coverage and care. Every case has been verified.
· a woman with severe Post Traumatic Stress Disorder as a result of sexual violence in her country of origin cannot be treated because she has to wait for her IFH coverage to be initiated
· a man is found to have a mass in his liver after an Emergency room visit. He does not have any insurance to follow up because he is from a Designated Country of Origin (DCO) and cannot pay for it himself
· a woman fleeing the sex trade arrives in the late stages of pregnancy and cannot get any testing as she awaits her IFH coverage
· a six year old child cannot get proper investigations for a possible urinary tract infection as she awaits her IFH coverage. The family cannot pay for the treatment
· a woman with a biopsied mass in her neck cannot get a follow up appointment to get her results even though she has health coverage through the IFHP
· a woman with a large mass in her pelvis cannot get diagnostic or curative surgery because she is denied refugee status during the work-up
· a woman in labor is asked to pay for the cost of her epidural as the anesthetist is unable to understand her IFHP insurance coverage late at night. She delivers her baby without pain control
· a woman requiring treatment of fibroids and heavy vaginal bleeding is denied coverage for a necessary pelvic ultrasound.
“The government should listen to the 20 national health care organizations as well as that of many provincial governments and
rescind these cuts now,” added Dr. Rashid.
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / ChristopherHolcroft@hotmail.ca
March 8th
Letter to Minister Kenney re: IFHP cuts from the Catholic Health Alliance of Canada - http://www.chac.ca/letter%20to%20minister%20kenney%202013.pdf
Young resident doctors lead a nation-wide protest against the cuts to refugee healthcare
Healthcare providers, led by young resident doctors, mobilized across the country on December 15 to oppose the next phase of cuts to the Interim Federal Health Program, which dramatically restrict healthcare coverage for some refugees. On December 14, Immigration Minister Kenney released the first list of 27 “safe”countries, from which refugee claimants will be fast-tracked with no right of appeal and who will receive no healthcare coverage, except for conditions deemed a threat to public health and safety.
Healthcare professionals—from physicians to midwives to pharmacists—are calling on the federal government to reinstate equitable healthcare coverage for all refugees.
Over 80 healthcare providers gathered for a candlelight vigil at Toronto's Nathan Phillips Square to demand that the Interim Federal Health Program be immediately and fully restored. They collected signatures on a 6 foot holiday card, as well as
individual holiday cards, addressed to Minister Kenney calling for a reversal of the cuts to refugee healthcare and continued their protest into the crowded Eaton Centre.
In Vancouver, approximately 50 individuals gathered at the Immigration and Refugee Board offices to hold vigil for 2 hours.
Community and health care workers spoke against the cuts while passersby signed cards of protest for the Minister of Citizenship, Immigration, and Multiculturalism. Similar events took place in Montreal, Winnipeg, and Kingston.
“Cutting refugee health care is an unfair and costly decision that goes against Canadian values and will lead to devastating consequences for some of the most vulnerable of our society,”explained Residents for Refugee Care.
The physicians and healthcare providers have pledged to follow the impact of these cuts and report them over the coming months.
Media Advisory
Attention: Assignment desks, health and immigration reporters
Resident Doctors will hold candlelight vigil to protest next phase of refugee health care cuts
Healthcare providers will join doctors in training in holding a candlelight vigil December 15th to mark the implementation of the next phase of cuts to the Interim Federal Health Program (IFHP). The peaceful demonstration will offer the public the opportunity to write “cards to the Honourable Jason Kenney” to request their holiday wishes for reinstating health coverage for refugees. On
December 14th, the Minister of Citizenship, Immigration and Multiculturalism Jason Kenney released the Designated Country of Origin (DCO) list; new refugee claimants from countries on this list will have no health care coverage except for conditions that pose a threat to public health or safety. The DCO list includes countries that the government arbitrarily deems “safe”,
notwithstanding the potential for persecuted minorities within these countries.
This latest phase of cuts to the IFHP will make some of the most vulnerable people in our country even more vulnerable. For example, heart attack victims who are refugee claimants from countries on the DCO list will have no access to lifesaving treatment; pregnant women will receive no health care. Healthcare providers speaking out against the cuts to refugee health services are calling on the federal government to reinstate equitable health care coverage for all refugees and refugee claimants.
Who: Medical residents, students, physicians, other healthcare providers and any supporters of refugee health care
What: White coat candlelight vigil to protest the next phase of federal cuts to refugee health services.
When: December 15th, 4:00 pm
Where: Speaker’s Corner, Nathan Phillips Square, Toronto City Hall, 100 Queen Street West
Why: Cutting refugee health care is an unfair and costly decision that goes against Canadian values and leads to devastating
consequences for some of the most vulnerable of our society
Smaller events are being organized in other cities:
· Montreal: 4 pm in front of the Eaton Centre;
· Vancouver: 1pm in front of the CIC offices at 300 W Georgia St (near the library); contact is Thomas Warren -- tom.mackenzie.warren@gmail.com
· Kingston: 11 am in front of City Hall; contact is Chantalle Brace -- cbrace@qmed.ca
· Calgary: TBD; contact is Dr. Jia Hu -- jiahu17@gmail.com
Further background information on the Interim Federal Health Program cuts is available at: www.doctorsforrefugeecare.ca.
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For more information please contact:
On-site
Dr. Alexander Caudarella: 647-463-2539; resrefugeecare@gmail.com
Dr. Hasan Sheikh: 647-985-9454; resrefugeecare@gmail.com
Christopher Holcroft – Principal, Empower Consulting; Cell: 416-996-0767/ Chris_Holcroft@yahoo.com
Please see this statement from the Canadian Healthcare Association:
http://www.cha.ca/wp-content/uploads/2012/11/IFHP-reform-policy-statement-November-2012.pdf
For immediate release
Canadian Doctors for Refugee Care warns of more chaos, serious health risks to come
Toronto, December 4, 2012 – With the federal government announcing that it will be revealing its Designated Countries of Origin list to inform its handling of refugees on December 15th, Canadian Doctors for Refugee Care is warning provincial governments, medical professionals and health institutions to brace for more chaos and cases of individuals not being eligible for care. The announcement is particularly disheartening given the government’s unwillingness to meet with health care organizations to talk about the difficulties the changes to the Interim Health Program (IFHP) have already caused, or consider alternative options.
On October 2nd Canadian Doctors for Refugee Care submitted a written proposal (outlined below) to Citizenship, Immigration, and Multiculturalism Minister Jason Kenney that addresses the federal government’s stated equity concern while maintaining access to important health care services for refugees. The same proposal was previously sent to Dr. Danielle Grondin, Director General of the Health Branch of the Ministry of Citizenship, Immigration, and Multiculturalism on July 31. To date, Canadian Doctors for Refugee Care has received no direct response to its proposal.
The consequences of the government's cuts to refugee health insurance continue to mount. Premier Wall of Saskatchewan has joined the increasing number of voices that have denounced these cuts as being an affront to Canadian values. The recently publicized case of a man denied access to chemotherapy is not an isolated incident. The situation will become much worse
after December 15th.
Once a country is placed on the Designated Countries of Origin list by the Minister of Citizenship, Immigration, and Multiculturalism, refugees from that country who submit a claim after December 15th will only be eligible for health care coverage deemed necessary for public health and safety. There is broad speculation that this list will include Hungary and the Roma refugees fleeing persecution there.
“The number of cases we have seen of patients needing access to, but denied care will be multiples higher after December 15th,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College Hospital. “After that date Canada will be telling some of the most vulnerable people in the world that they are not worthy of basic health care, including for refugees who have heart attacks and pregnant women refugees and their children.”
The group also continues to document an ever escalating number of refugee claimants entitled to IFHP coverage who are being denied health care. Ministerial mismanagement has caused dozens of IFHP-eligible claimants to go without care, and doctors are unable to decipher the impenetrable web of rules and grids established by the Ministry.
Canadian Doctors for Refugee Care has verified every case that has been released to the public.
“The only response by the government has been accusations that Canadian Doctors for Refugee Care is ‘purposefully altering’ the facts of the cases the group has documented,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “As between the doctors and the government it is not the doctors who are engaged in misrepresentation."
The following is a sample of cases catalogued by the Canadian Doctors for Refugee Care in which IFHP entitled refugee claimants have been refused coverage and care:
· A young child from Africa with a high fever but has no health insurance because his IFHP has not been activated
· A woman in her third trimester of pregnancy develops pre-eclampsia, a potentially lethal disease, but has no coverage to treat her condition
· A man with a rectal mass is turned away from care a multitude of times although he should have health insurance according to the government's own policy
· A young child from Africa could not get a chest X-ray after her IFHP was issued but there was a delay in its implementation. She eventually was found to have pneumonia
· A man is scheduled for surgery for a kidney stone causing an enlarged kidney but may have to cancel the surgery as he waits over two months for renewal of his coverage
· Two young children with multiple hospitalizations for asthma cannot get access to their inhalers leaving them at risk for seeking out care through emergency departments
· A woman missed her opportunity to get prenatal screening because she awaits the initiation of IFHP coverage. The baby will be a Canadian citizen.
"Refugee claimants are not tourists or illegal immigrants,” said Dr. Berger. “They are people seeking refuge and safety in Canada; they are here legally, within our borders, doing what they are supposed to be doing. Many will become Canadian citizens. The federal government should rescind the cuts and continue Canada's historical and ethical tradition of caring for refugees."
"It is time to suspend the cuts and find a better and more Canadian way to achieve the government's goal of equity and at the same time protect the health of refugees,” said Dr. Rashid.
Proposal submitted to federal government on IFHP cuts:
Preamble:
· Refugees in any category should have health care coverage equivalent to (and no more than) Canadian citizens in the same economic circumstances.
· In particular, refugee category and country of origin, should not determine access to such health care.
· Everyone residing in Canada with the intent of staying in Canada must have access to such care, both for public health and humanitarian reasons.
· Some sectors of the population have greater health needs including seniors, First Nations peoples, and poorer Canadians and as such require greater care than other Canadians; refugee claimants and refugees similarly require greater care arising from pre migration trauma, poverty, and years of neglected health.
Proposal:
· We propose that a threshold income/asset level to determine eligibility for the Interim Federal Health Program be applied to refugees. This threshold would be determined using a process that acknowledges the unique needs of refugees, but may look to applicable provincial social assistance income/ asset thresholds as a guide.
· Refugees in any category who fall below this threshold should be eligible for health care coverage including all medical services, medications, vision/dental care, medical aides /appliances, and any other benefits provided to social assistance recipients.
· Refugees in any category who do not meet this threshold would still be covered for health services equivalent to those provided under provincial health insurance plans.
· Refugees who do not meet the threshold but who are low-income earners should be eligible for any medication or other expense subsidization equivalent to those provided by provincial subsidization programs.
- Under this proposal equity with Canadians is achieved and refugees in any category will receive necessary health coverage.
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / ChristopherHolcroft@hotmail.ca
For immediate release
Canadian Doctors for Refugee Care releases more cases of vulnerable people being denied access to care; calls on government to put aside rhetoric and resolve issue
Toronto, October 23, 2012 – One month after Canadian Doctors for Refugee Care released a number of examples of patients being denied access to necessary health services due to the cuts to the Interim Federal Health Program (IFHP) and its resulting confusion, the group is releasing another round of troubling cases.
Canadian Doctors for Refugee Care, a non-partisan group of physicians with firsthand experience treating refugees in cities and towns across the country, has been documenting specific patient cases since the changes to federally funded refugee health care services were announced June 30th.
The group is disappointed by the continued lack of a rational response from the federal government to its concerns. Following the last release of documented cases, the government’s public response was to question the group’s methodology and accuse it of having“purposely altered” the facts.
“Rather than trying to discredit the messenger and our evidence-based reports, we encourage the government to put reason over rhetoric and work with us to resolve this issue,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We continue to see the devastating impact of these IFHP cuts on patients and their families, and see the strain this is putting on our public health system.
All cases collected by Canadian Doctors for Refugee Care are provided by the refugee's health care provider. Patients provided consent to their provider to disclose their stories. Their cases were rigorously vetted in some cases by independent chart reviews and by independent interviews with refugees and in other cases by speaking directly with the health care provider. All personally
identifying information has been removed to protect the privacy and identity of the refugee, including age, country of origin, date of arrival and city/province of current residence. Most refugees are too frightened to speak publicly.
In addition to the individual cases that are brought to our attention, we continue to hear about refugees being denied access to health care or medical clinics refusing to treat patients, even with IFHP coverage, because of confusion surrounding the
program. Clinics that specialize in treating newcomers as well as free medical clinics are being inundated with patient requests that are far outstripping their capacity to provide important health services.
There also continues to be great anxiety about the public release of the list of Designated Countries of Origin – which will greatly reduce coverage for some refugees including for heart attack patients and pregnant women and their babies.
“We want to work with the government to resolve this issue now – before there is a medical emergency we are unable to treat,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “It is time for the Minister to finally talk to the doctors treating refugees and meet with the major Canadian health organizations opposed to these cuts.”
Canadian Doctors for Refugee Care has recently submitted a proposal to Citizenship, Immigration and Multiculturalism Minister Jason Kenney that it believes offers a workable resolution to the issue while restoring necessary health coverage for refugees. The group will provide a public update as to the contents and status of this proposal in the near future.
The following is a new sampling of patient outcomes as reported by physicians:
· A teenager with Post Traumatic Stress Disorder and previous suicide attempts who has valid IFHP coverage is cut off from essential psychiatric medications
· A young girl from an area with malaria has a high fever but does not have health coverage to rule out malaria as she awaits her IFHP to be initiated
· A child with a potentially contagious rash is turned away from a clinic because her IFHP coverage, although valid, was not accepted by the clinic.
· A child with cough, fever and vomiting is only able to access care at a free clinic due to confusion around IFHP coverage
· Two children with severe asthma cannot get the medications they require to treat their illness due to delays in initiating IFHP coverage which have been occurring routinely since June 30, 2012
· A woman arrives in Canada pregnant but cannot get adequate testing to monitor her pregnancy as she awaits her IFHP coverage to be implemented
· A woman very late in her pregnancy is turned away by her regular doctor despite being eligible for IFHP coverage.
“This is about a vulnerable population not receiving access to health care,” said Dr. Rashid. “Our compassionate instincts as Canadians and the evidence points to the IFHP cuts being bad policy. Let’s fix this now.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767 / Chris_Holcroft@yahoo.com
Health care providers to rally in front of Conservative MP Kelly Block’s House of Commons office to protest offensive, misleading constituent flyer about federal government cuts to refugee health services
Health care workers from Ottawa and Saskatchewan are protesting an inflammatory and misleading constituent flyer from Conservative MP Kelly Block today. The health providers will be rallying in front of her House of Commons office at 730 La Promenade at 2 pm.
On Thursday October 11, constituents of Saskatoon-Rosetown-Biggar received a flyer out of MP Kelly Block’s office describing the cuts to the Interim Federal Health Program and stating that “new arrivals to Canada have received dental and vision care paid by your tax dollars. They’ve had free prescriptions. Not anymore.” Included in the flyer is a survey asking constituents to choose between two options: “I agree with Kelly Block! Newcomers don’t deserve more benefits than Canadians.” or “I disagree. Refugee claimants should get dental, vision and pharmacare even if I don’t.”
The health providers believe this flyer to be offensive and divisive, pitting Canadians against each other and against vulnerable populations in particular. Organizers also believe that the cuts to the Interim Federal Health Program will lead to poorer health outcomes for our society’s most vulnerable, increase health care costs and threaten public safety.
Who: Physicians, nurses, community health workers and many others from a number of different professional health disciplines
What: A rally to protest an offensive flyer sent by Conservative MP Kelly Block and cuts to refugee health care services
When: 2:00 PM Monday, October 22nd, 2012
Where: In front of MP Kelly Block’s office in Ottawa, 730 La Promenade, House of Commons.
Why: Reducing access to important health care services for refugees is an expensive public health risk and inconsistent with our values as a country, and so is pitting Canadians against each others and against vulnerable populations.
For more information or to arrange an interview please contact:
Mahli Brindamour
(306) 270-8739
mahli.brindamour@gmail.com
For immediate release
Canadian Doctors for Refugee Care releases update on impact of federal cuts to refugee health services
Toronto, September 27, 2012 – Three months after dramatic cuts to federally funded refugee health care services took effect, the program that manages these services is marred by confusion, unnecessary costs, and compromised care. These are the interim
findings from Canadian Doctors for Refugee Care, a non-partisan group of physicians with firsthand experience treating refugees in cities and towns across the country. The group has been documenting dozens of specific patient cases since the changes to the Interim Federal Health Program (IFHP) were announced June 30th.
“The IFH Program is in disarray and being mismanaged and the health of all refugees is being placed at risk,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital. “We advised the government from the beginning that these program cuts would reduce care, increase costs to other areas of the health system and needlessly threaten public safety, and regrettably, this is exactly what our colleagues are seeing in clinics and hospitals across Canada.”
Our reporting indicates a wide cross section of refugees being denied access to health care, with pregnant women and their babies being particularly impacted. Newly arrived refugees do not qualify for health care coverage for many weeks after making a claim. Many women are not receiving appropriate care for their pregnancy as a result. Six such cases have been seen at one small clinic alone in the last three months. The lengthy waiting period for coverage also affects refugees arriving from areas where they have been exposed to a myriad of health risks.
Another troubling finding is that many clinics and hospitals are refusing care to refugees because of a lack of clarity around IFH coverage rules and the inability of the government’s private sector insurance company, Blue Cross, to provide definitive information. In a separate survey of 30 walk-in clinics in the Toronto area, only five could clearly state they were accepting IFH coverage for refugees and understood the new rules.
While the decision by the federal government over the summer to reverse some of its planned cuts to the IFH Program lessened the severity of these cuts, there is still great uncertainty and anxiety about the changes to the IFH Program, particularly given that the list of Designated Countries of Origin – which will determine further reductions in coverage for some refugees – has yet to be publicly released.
“The government is telling some of the most vulnerable members of society they are not eligible for important, possibly life saving health coverage,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital.
In some parts of the country, provincial governments have stated they will pay for some health services that are being cut from the IFH Program. Yet provincial governments are also forced to pay for services that are being accessed – such as emergency room visits – as a last resort by refugees desperate for care and cut off from less expensive means such as primary care and
medications.
The following is a sampling of patient outcomes as reported by physicians across the country:
· A man requiring urgent eye surgery to prevent blindness is refused IFH coverage because he is said to be an “illegal migrant expected to leave the country”.Ten days later he receives notification from Citizen and Immigration Canada that he is eligible for permanent residency status.
· A young female refugee claimant is 18 weeks pregnant as a result of a sexual assault while being used as a sexual slave. She has no IFH coverage to address the pregnancy.
· A refugee claimant, 36 weeks pregnant, is told by her obstetrician that IFH will no longer provide insurance for her pregnancy or delivery and to bring in $3000 for her next appointment. After weeks of anxiety and investigation, the IFH program admits they made a mistake and the woman will be covered.
· A male refugee claimant experiencing chest pain and having characteristics that makes his physician suspicious of tuberculosis is not eligible for a chest x-ray.
· A female accepted refugee with asthma has an avoidable emergency room visit and hospitalization because of a lack of medication.
· A female refugee claimant with fibroids and adenomyosis has surgery cancelled due to her IFH status. As a result, the patient has numerous emergency room and doctor’s office visits for severe pain.
· A male refugee applicant will have his IFH coverage expire shortly. He has three children, two requiring immunizations and a third requiring follow-up on an operation on his aorta at birth. They were turned away from two clinics and unable to see a physician.
· A female refugee claimant who is a senior with diabetes and chronic kidney disease has her condition deteriorate because of lack of access to medication, regular blood testing and monitoring, and dietician education.
· A teenage refugee claimant has a high risk pregnancy, potentially life-threatening. She is still waiting on eligibility for renewed IFH coverage. In the interim she hopes to avoid unnecessary complications and hospitalizations.
· A refugee claimant who is a mother of two is told by Citizenship and Immigration officials that she would no longer be eligible for IFH coverage after June 30th unless it was an emergency. She has therefore been unable to seek treatment for high blood pressure.
· A refugee claimant, 32 weeks pregnant, presents at two emergency rooms suffering from lower abdominal pain. On both occasions she is told that she would have to sign a document stating that she would be responsible for the costs of her visit. She leaves the emergency room on both occasions without being seen.
· A man admitted to hospital with congestive heart failure and 12 other medical conditions is discharged home without the necessary home care follow up, placing him at a much higher risk of readmission.
Canadian Doctors for Refugee Care is renewing its call for the federal government to reconsider its changes to the IFH Program. At the very least, the group recommends the Standing Committee on Citizenship and Immigration conduct a thoughtful, thorough evaluation of the impact of the cuts to the IFH Program.
“Physicians will continue to track individual patient cases and report back on our findings,” said Dr. Rashid. “We are not going away until the government does the right thing and completely reverse these reckless health care cuts.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
One physician's perspective on cuts to IFH program
Dr. Paul Caulford runs a clinic in Scarborough for people without health insurance. He has noted a dramatic increase in people presenting to his clinic since the cuts to IFH took effect. For those that are interested he has begun to document some of his stories though a blog at http://refugeediaries.ca/.
Health Care Coverage Table for Refugee Claimants and Refugees in Ontario
Please see the following link for an overview of health care coverage for refugee claimants and refugees in Ontario since the changes to the Interim Federal Health Program. The table applies specifically to Ontario, as there are certain differences between provinces. Although all information has been carefully checked by experts in refugee law and health policy, they cannot guarantee accuracy or completeness.
http://health4all.ca/sites/health4all.ca/files/refugee%20health%20care_Ontario_Aug.2012.pdf
For immediate release:
Government backs down again on another aspect of refugee health cuts but many refugees still being denied
care
Toronto, July 26th, 2012-The Federal Government has quietly backed down on another element of its proposed cuts. When the cuts were announced in April, 2012, care for most refugees was to be confined to “urgent and essential care”. Government
documents stated that care would not be provided for issues such as birth control or hip replacements. Now, without announcement or explanation, the Citizenship and Immigration Canada website states that most refugee claimants and privately sponsored refugees will have health coverage similar to provincial health programs where such services are covered. This is an important step toward protecting refugee health, but the unannounced reversals in policy are sowing confusion amongst health care providers and refugees.
Despite this reversal, many refugees continue to be denied access to health care. In particular, newly arrived refugee claimants are now denied health insurance for up to six weeks after arrival. This has resulted in people not being able to access care even after arriving from areas where they have been exposed to a myriad of health risks.
“We have seen a number of cases where people have required assessments for potentially very serious conditions but they lack the insurance to obtain investigations or treatments,” said Dr. Meb Rashid of the Crossroads Clinic at Women’s College Hospital.
Dr. Rashid points to a case of a woman who arrived 18 weeks pregnant due to sexual violence she suffered while forcibly confined in her home country. “I was unable to provide the necessary care for her pregnancy; even obtaining an ultrasound became a challenge as she had absolutely no health insurance. This places refugees at great risk but also imposes a risk to refugee-receiving communities”.
Dr. Tim O’Shea of Hamilton expressed concern about the confusing new bureaucracy in place to administer the changes to refugee health insurance. “Physicians are asked to contact the administrator of the health insurance program to confirm eligibility before
each patient visit,”said Dr. Shea. “This is impossible in any busy office. Also, their offices close at 4:30 pm and when they are reached they often state they will call back in 24 to 48 hours. It is absurd. With all the reversals in the program and the complexity of how it is administered, we are hearing numerous cases of patients who are not seeking out care because they incorrectly believe they are not covered. We are also hearing stories of physicians who are unable to decipher who is covered and for what services. This roll out has been a nightmare and has unnecessarily put patients at risk.”
Dr. Megan Williams, from Somerset West Community Health Centre in Ottawa, is urging the federal government to abandon it s health cuts altogether. “We are asking the government to rescind the cuts to health insurance so that all refugee patients have access to the same health care services that are available to other low income Canadians,” said Dr. Williams. “It is becoming clear that the government acknowledges that these cuts are misguided and costly and is quietly reversing elements of their initial
policy. We would ask them to continue this reflection and to rescind the cuts in their entirety.”
Canadian Doctors for Refugee Care encourages the government to heed the warnings of the numerous national health care organizations such as the Canadian Medical Association that have asked the government to reverse these cuts. We are pleased by the second reversal of elements of the policy but demand that the government reverse all of the cuts and stop needlessly putting vulnerable communities at risk.
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For more information or to arrange an interview please contact:
Dr. Meb Rashid (Toronto) 416-315-1270 mebrashid@hotmail.com
Dr. Megan Williams (Ottawa) 613-816-0850 mwilliam@swchc.on.ca
Dr. Mark Tyndall (Ottawa) 613-979-3098 mtyndall@toh.on.ca
Tim O’Shea (Hamilton) 289-237-8597 toshea99@gmail.com
Dr. Mike Dillon (Winnipeg) 204-330-1703 mdillon@klinic.mb.ca
Dr. Robert Martin (Vancouver) 778-232 6939 cabbagesandkings1@gmail.com
Dear Canadian healthcare provider,
The purpose of Refugee Health Outcome Monitoring and Evaluation System (Refugee HOMES) is to monitor the effects of changes to the Interim Federal Health Program effective from 30 June 2012 on adverse health outcomes experienced by refugees in Canada. The online data submission from can be accessed at:
http://www.surveymonkey.com/s/66KPGVS
Ou, en français à:
http://www.surveymonkey.com/s/WD9DHMS
This adverse outcome monitoring system relies on accurate and timely information being provided voluntarily by you, the care provider. It is important to both quantify the impact of the changes in coverage and to share the stories of the people affected. Please promptly and without exaggeration or embellishment report all adverse outcomes suffered by refugees that are related to healthcare or medication access.
Details of the changes to the Interim Federal Health Program and the new classification system for refugees based on their country of origin can be found on the Citizenship and Immigration Canada website:
http://www.cic.gc.ca/english/refugees/outside/coverage.asp
Please complete one form for each independent adverse outcome. You may complete multiple forms for a single patient if the patient has suffered multiple independent adverse outcomes, or if the severity of an adverse outcome has changed significantly (e.g. complete a second form if a patient who was hospitalized for angina suffers a myocardial infarction). Do not complete multiple forms for the same adverse outcome.
The only mandatory field is the contact information of the care provider completing the form. This information may be used to verify the accuracy of information on this form or to obtain additional information about the adverse outcome but it will not be used for any other purpose.
Please do not include any information that would allow individual patients to be identified. Please indicate on the form if you, the patient or a representative of the patient are willing to publicly explain how the patient was affected by the changes to the Interim Federal Health Program.
Any potentially preventable deaths should be both reported using this form and promptly reported to the appropriate coroner or medical examiner.
We will periodically publicize summaries of the adverse outcome data collected across Canada. We will also make periodic updates to this data collection form and we welcome your feedback.
Please notify your colleagues of this important monitoring system by, for example, circulating this letter. Thank you very much for your diligence.
Sincerely,
Refugee HOMES Team
For immediate release
Canadian Doctors for Refugee Care unveil plan to monitor consequences of federal cuts to refugee health services
Ottawa, June 27, 2012 –With the clock about to strike midnight on refugee access to important health care services, Canadian Doctors for Refugee Care are making a final plea to the federal government to save these services from pending cuts to the Interim Federal Health Program. The group is also unveiling a plan to monitor the health consequences of these cuts, set to take effect June 30th.
“The federal government still has time to reverse these irrational and inhumane health care cuts,” said Dr. Mark Tyndall, Professor of Medicine, University of Ottawa and Chief of infectious diseases, The Ottawa hospital.. “At the very least, we call on Minister Kenney to suspend these cuts and conduct a true consultation with health professionals who, en masse, have warned of the potentially devastating impact of these cuts on public health and safety.”
Canadian Doctors for Refugee Care is part of broad coalition of national associations and grassroots health providers deeply concerned that the federal cuts to refugee health services will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety. For example, many refugees accepted to, and living in, Canada will no longer qualify for coverage for necessary medications such as insulin. Some refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all categories of refugees are: prenatal care for pregnant women, well child care and even care for heart attacks and
some other medical emergencies.
On June 18th, Canadian Doctors for Refugee Care helped organize demonstrations in 14 cities across the country that were attended by more than 2,000 health providers. This unprecedented level of solidarity within the health care community has prompted a commitment from physicians across the country to participate in a program designed to track the consequences of the health cuts on refugees.
“We are not giving up,” said Dr. Philip Berger, Chief of Family and Community Medicine at St. Michael’s Hospital in Toronto. “If the government will not track the consequences of these changes physicians will. Perhaps when the government sees, quite literally, the devastating and lethal impact of these cuts it will do the right thing and restore basic health coverage to all refugees.”
Canadian Doctors for Refugee Care will have in place by June 30th a nation-wide surveillance system that will have the capacity to track and analyze instances of adverse health outcomes on refugees as a result of the changes to the Interim Federal Health Program. This network of physicians across Canada will be reporting the details of any such cases in to a centralized data collection system. The group will then collate and report these stories back to Members of Parliament, the media, and the general public
on a regular basis. Physicians are also contacting their respective provincial coroners to alert them to the changes.
“I stand before you today as living evidence of the Canadian dream – a dream built on dignity, opportunity and compassion,” said Dr. Parisa Rezaiefar, a refugee who came to Canada and is now a family physician at the Bruyere Academic Family Medicine
Centre, a lecturer at the University of Ottawa and emergency room physician at the Children Hospital's of Eastern Ontario. “I urge Minister Kenney to not take away that dream from today’s refugees and tomorrow’s citizens. The Interim Federal Health Program is not charity; it is an investment in the future of the country.”
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
Media Advisory
Canadian Doctors for Refugee Care to unveil plan to monitor consequences of federal cuts
to refugee health services
Canadian Doctors for Refugee Care, a group of grassroots physicians who have been working with other health care workers opposed to changes to the Interim Federal Health Program will be holding a press conference to make a final plea to the government to protect vital health services for refugees. The physicians will also unveil a national plan to monitor and publicly report on the health consequences of federal cuts to this program.
Doctors and other health care workers are deeply concerned that the cuts, set to come into effect June 30, will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety. On June 18th, Canadian Doctors for Refugee Care helped organize demonstrations in 14 cities across the country that were attended by more than 2,000 health providers. More than a dozen national health care associations are also opposed to these changes. This is an unprecedented show of solidarity
among the health care community.
Who: Members of Canadian Doctors for Refugee Care
- Dr. Parisa Rezaiefar, Family Physician, Bruyere Academic Family Medicine Centre
- Dr. Mark Tyndall, Chief of Infectious Diseases, The Ottawa Hospital and the University of Ottawa
- Dr. Philip Berger – Chief of Family and Community Medicine, St. Michael’s Hospital
What: Press conference to outline next steps in groups’campaign against cuts to refugee health care
Where: The Charles-Lynch Press Conference Room, Centre Block of Parliament, Ottawa
When: Wednesday, June, 27th at 11:00 a.m. EST
Why: The federal cuts are likely to have devastating consequences for the health of refugees, are an expensive public health risk, and are inconsistent with Canadian values
More information can also be found on our website at www.doctorsforrefugeecare.ca.
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For more information please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
chris_holcroft@yahoo.com
The Department of Psychiatry at the University of Toronto expresses concerns about changes to refugee health coverage:
http://www.utpsychiatry.ca/bill-c31-uoft-psychiatry-position-statement/
Amnesty International expresses concerns about changes to refugee health coverage:
http://www.amnesty.ca/media2010.php?DocID=1617
The Public Health Association of British Columbia releases its position on changes to refugee health care:
http://phabc.org/userfiles/file/PHABCPositiononChangestoHealthCareCoverageforRefugees(1).pdf
The Ontario Medical Association voices concerns about planned changed to the IFH
Program: http://www.newswire.ca/en/story/994261/refugee-health-changes-a-concern-ontario-doctors
Response to the Interim Federal Health Program Cuts and Bill C31 by Health Professionals of McGill University Department of Psychiatry - http://www.mcgill.ca/psychiatry/sites/mcgill.ca.psychiatry/files/bill_c31_mcgill_en.pdf
For immediate release
Health care workers to hold National Day of Action June 18th to protest planned federal government cuts to refugee health services
Unprecedented events being organized in 10 cities across the country
Toronto, June 12, 2012 –Health care workers united in opposition to planned reductions in health care coverage for refugees are holding a national day of action in hopes of persuading the federal government to reverse course. Physicians, nurses, community health workers and many others from a number of different professional health disciplines will be participating in demonstrations in 10 cities from coast to coast on Monday, June 18th. The health care workers are deeply concerned that the changes to the Interim Federal Health Program (IFHP) scheduled to take effect June 30, 2012 will lead to poorer health outcomes for some of the most vulnerable members of society, increase health care costs and threaten public safety.
“Many health care workers, especially in urban areas throughout Canada, treat refugees on a daily basis,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We listen to their stories of enduring war and violence and being separated from their families. We believe it is inhumane to deny them access to the health care they need to begin their new lives in Canada. This is at the heart of why we are demonstrating on June 18th.
The federal government recently announced plans to cut important health care services for refugees as of June 30, 2012. For example, many refugees accepted to, and living in, Canada will no longer qualify for coverage for necessary medications such as insulin. Some refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all refugees are: prenatal care for pregnant women, well child care and access to mental health care.
Health care workers will also be using the demonstrations as an opportunity to clarify some of the facts over the planned IFHP changes, such as:
· There will not be cost savings. Restricting access to preventive care leads to repeated emergency room visits and hospitalizations that increase costs to the health system.
· The risks to public safety will be greater. Most patients only pose a public health risk if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they become very sick, they will likely have already infected others.
· These changes do not bring fairness to the health system. Refugees do not currently receive better health care than other Canadians. In fact, IFHP coverage does not provide broader insurance than what is available to another vulnerable population, low-income Canadians.
· We need not fear refugees abusing the health system. Engaging vulnerable populations in preventative and primary care is challenging enough as it is, and access to a high standard of health care would be a low priority for refugees who are used to struggling just to survive.
“We encourage the federal government to listen to reason and act with compassion,” said Dr. Gary Bloch, a family physician with St. Michael's Hospital. “Maintaining a healthy community means ensuring all members of the community – including refugees – receive basic, medically necessary care. This is the Canadian way.”
Schedule of events
· Toronto – 1 pm -demonstration outside the Citizenship and Immigration Canada office at 25
St. Clair Avenue East
· Hamilton – 1 pm -demonstration outside the Citizenship and Immigration Canada office at 55 Bay Street
North
· Ottawa - Noon –demonstration on Parliament Hill
Montreal - 12:30 pm – demonstration outside the Citizenship and Immigration Canada office at 1010 St. Antoine Ouest
· St. John's - There will be a press conference held, details TBC, please check www.doctorsforrefugeecare.ca
for updates
· Winnipeg - Noon –Demonstration at the Forks Plaza
· Saskatoon - Noon –Demonstration and parade at Kiwanis Memorial Park
· Calgary - Noon –Demonstration at Harry Hays Building at 220 4th Ave SE
· Edmonton – Demonstration to be held, details TBC, please check www.doctorsforrefugeecare.ca for
updates
· Vancouver - Noon –demonstration outside the Citizenship and Immigration Canada office at 1148 Hornby Street
Among the health care organizations supporting the national day of action on June 18th:
Canadian Doctors for Refugee Care * College of Family Physicians of Canada * Royal College of Physicians and Surgeons of Canada * Canadian Association of Optometrists * Canadian Association of Social Workers *
Canadian Dental Association * Canadian Medical Association * Canadian Nurses Association * Canadian Pharmacists Association * Canadian Association of Community Health Centres * Canadian Association of Midwives * Canadian Paediatric Society * Canadian Psychiatric Association * Association of Medical Microbiology and Infectious Diseases Canada * Canadian Federation of Medical Students
More information is available at: www.doctorsforrefugeecare.ca.
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For more information or to arrange an interview please contact:
Christopher Holcroft
Principal
Empower Consulting
416-996-0767
Chris_Holcroft@yahoo.com
The Department of Family and Community Medicine, University of Toronto, released the following position statement about the planned IFH program changes:
http://www.dfcm.utoronto.ca/about/newsevents/news/060612-1.htm
The Canadian Psychiatric Association adds their voice to the growing concerns about planned health care cuts for refugees in this letter to Minister Kenney: http://www.cpa-apc.org/media.php?mid=1742
The Canadian Paediatric Society warns cuts to refugee health program will put children & youth at risk:
http://www.cps.ca/English/advocacy/CPS_RefugeeHealth.pdf
Candians Doctors for Refugee Care released an open letter it sent to Canada's Provincial Ministers of Health today - please read the text of the letter below.
Open letter to Provincial and Territorial Health Ministers from Canadian Doctors for Refugee Care
June 5, 2012
Dear Minister:
We are writing to alert you to an issue that will threaten public health in your province, divert precious provincial health care dollars and likely challenge federal-provincial relations.
The federal government recently announced plans to cut important health care services for refugees as of June 30, 2012 with sweeping changes to the Interim Federal Health (IFH) program. Refugees living in Canada will no longer be able to access care unless it is deemed urgent or essential. What is urgent or essential has not yet been defined but it is clear preventative care will no longer be covered. In addition, all refugees will lose access to medications such as insulin and emergency dental and vision care. Depending on their country of origin, refugee claimants will be denied access to physicians all together unless their condition is deemed a threat to public health or safety. Among other health care services to be cut for some or all refugees are: prenatal care for pregnant women, well child care and access to mental health care.
On May 11, physicians in cities across the country, many of whom treat refugees on a daily basis, organized demonstrations, press conferences and public events to protest these changes. Following an overwhelming positive response from the medical community and public at large, these physicians have come together to launch Canadian Doctors for Refugee Care.
We are deeply concerned that denying refugees access to preventative care, key medications and diagnostic exams will:
• Risk outbreaks of public health threats such as tuberculosis
• Force provincial governments to address refugee health care via expensive acute and critical care services instead of primary care resources paid for by a federal government program
• Strain federal-provincial relations as the provinces will take on, de facto, refugee health as part of
growing citizenship and immigration responsibilities without an agreement or appropriate compensation
We are calling on all provincial and territorial governments to stand with us and oppose these changes on the grounds that they are poor public health policy, create unnecessary burdens on local health systems - especially in urban centres and provincial capitals – and represent unjust treatment of refugees residing in this country, some of whom will have just escaped war, violence or famine.
On Monday, June 18 in cities across the country physicians and others opposed to cutting health services for refugees will be participating in a day of action. We hope that you will join us in this critical fight by advocating for the federal government to reverse its planned changes to the IFH program. We further hope that you will impress upon your federal counterparts the importance of Canada remaining a global leader in international justice, humanitarianism, and protectors of public health around the globe.
We would be pleased to provide you with further information or arrange to speak with you about this issue in greater detail. Please contact Christopher Holcroft at 416-996-0767 or chris_holcroft@yahoo.com if we can be of
assistance.
Sincerely,
Dr. Philip Berger
Dr. Gary Bloch
Dr. Jane Pritchard
On behalf of Canadian Doctors for Refugee Care
cc: Canada’s Provincial Ministers of Health
Canada’s Provincial Ministers of Citizenship and Immigration
Toronto Board of Health endorses formal position against the planned IFH cuts
http://www.toronto.ca/legdocs/mmis/2012/hl/bgrd/backgroundfile-47324.pdf
The Wellseley Institute released an equity analysis of the planned IFH cuts
http://www.wellesleyinstitute.com/health-care/toronto-board-of-health-sees-the-real-cost-of-cutting-refugee-health-benefits/
May 18 letter to Minister Kenney from national medical groups
Eight prominent national health care groups have written Minister Jason Kenney to register their opposition to planned federal cuts to health services for refugees, including:
Canadian Association of Optometrists
The Canadian Medical Association
The Canadian Nurses Association
The Canadian Association of Social Workers
The Canadian Dental Association
The Canadian Pharmacists Association
The College of Family Physicians of Canada
The Royal College of Physicians and Surgeons of Canada
You can read their letter here: http://www.pharmacists.ca/cpha-ca/assets/File/cpha-on-the-issues/SuppBenefitsKenneyEN.pdf
Press release from May 11th demonstration
May 11, 2012
For immediate release
More than eighty physicians descend on federal Minister’s office to protest planned cuts to health coverage for refugees
Toronto, ON – More than eighty physicians, many of them prominent members of the medical community representing a broad range of disciplines, have descended upon Conservative Minister Joe Oliver’s constituency office this hour as part of a national, grassroots effort to protect the modest health services currently provided to refugees. The physicians – some of whom intend to sit in silence inside the office while others rally public support outside – are seeking an emergency meeting with the Minister (the highest ranking member of the federal government in Toronto) to discuss planned changes to the Interim Federal Health Program scheduled to take effect June 30, 2012.
“Eliminating critical elements of health coverage for refugees is not only callous, it is poor health policy,” said Dr. Philip Berger, head of family medicine at St. Michael’s Hospital. “Maintaining a healthy community means ensuring all members of the community – including refugees – receive basic, medically necessary care. This is the Canadian way.”
Under the changes announced by the federal government on April 25th, refugees accepted to, and living in, Canada will no longer qualify for necessary medications such as insulin. A number of refugee claimants will also be denied access to physicians unless their condition is deemed a threat to public health or safety. In addition, there will be no coverage provided for addressing issues such as prevention of tuberculosis and well child care.
“Many doctors, especially in urban areas throughout Canada, treat refugees on a daily basis,” said Dr. Meb Rashid, medical director of the Crossroads Clinic at Women's College hospital. “We listen to their stories of enduring war and violence and being separated from their families. We believe it is inhumane to deny them access to the health care they need to begin their new lives in Canada.
Part of the rationale for the public action by physicians is to challenge the arguments being advanced by the government to explain the decision. Consider:
· There will not be cost savings. Restricting access to preventive care leads to repeated emergency room visits and hospitalizations that increase costs
to the health system.
· The risks to public safety will be greater. Most patients only pose a public health risk if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they are coughing up blood, they will likely have already infected others.
· We need not fear refugees abusing the health system. Engaging vulnerable populations in preventative and primary care is challenging enough as it is, and access to a high standard of health care would be a low priority for refugees who are used to struggling just to survive.
“We are extremely frustrated with the misinformation on this issue,” said Dr. Jane Pritchard, a family physician who works with refugees. “We do not see refugees requiring health care as a public drain on the system, instead we see future citizens protecting and improving their health as an investment that benefits the entire community.”
“We encourage the federal government to listen to reason and act with compassion,”said Dr. Gary Bloch, a family physician with St. Michael's Hospital. “If we want healthy, prosperous communities, refugees need medical treatment too.”
Minister Oliver’s constituency office is located at 511 Lawrence Avenue West, just west of Bathurst Street in Toronto.
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Mayy 11th letter to Minister Joe Oliver from Toronto physicians opposed to cuts in health care services for refugees
May 11, 2012
Hon. Joe Oliver
Minister of Natural Resources
Member of Parliament for Eglinton-Lawrence
511 Lawrence Avenue West
Toronto, ON M6A 1A3
Re: Meeting request to discuss planned changes to Interim Federal Health Program
Dear Minister,
We are writing to you on behalf of more than 80 physicians in the Toronto area who are deeply troubled by your government’s planned changes to the Interim Federal Health Program, scheduled to take effect June 30, 2012. As experienced doctors who see refugees as patients on a regular basis, it is our professional opinion that these changes will worsen health outcomes for refugees, put the health of the broader public at risk and lead to increased costs to the health system.
As you know Canada has a long and proud history of providing refuge to men and women around the world who are fleeing war, famine, political persecution, torture or violence. Part of that refuge includes providing individuals with basic health services. This is not only the compassionate act of a privileged country but it is also sound public health policy.
The planned changes will eliminate or restrict a wide range of important health services for refugees depending on their claimant status and Designated Country of Origin. Included among the health care services to be cut that will impact some or all refugees are: prenatal care for pregnant women, insulin for diabetic children and access to mental health services.
Restricting access to preventive care however leads to repeated emergency room visits and hospitalizations that increase costs to the health system. Reducing primary health care access also poses public health risks. For example, if a person with tuberculosis is only offered care after they are coughing up blood, they will likely have already infected others.
We believe the objectives of our group, and those of the government, namely a fair, just and affordable health care system, are aligned. We are therefore confident that a review of the facts of this issue will convince your government not to proceed with the planned changes to the Interim Federal Health Program. After all, protecting and improving the health of refugees – many of whom will become citizens one day – is an investment that benefits the entire community.
Given that these changes are scheduled to take effect in a few weeks, we are respectfully asking for a meeting at your earliest opportunity. Please have your office advise Dr. Philip Berger at 416-802-1191 when you are available for this meeting. Thank you in advance for your consideration of this request.
Sincerely,
Dr. Philip Berger
Dr. Gary Bloch
Dr. Jane Pritchard
Dr. Jesse McLaren
Dr. Meb Rashid
Cc: Hon. Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism
Right Hon. Stephen Harper, Prime Minister
