Citizenship and Immigration committee  We have evidence-based guidelines that were published just in 2011, and I would recommend that those were followed—that is, when immigrants arrive, they'd undergo a health screening as per the guidelines, which I can share with the committee if you want to see them. The work has been done, so that would be the easiest thing to do.

Citizenship and Immigration committee  In respect to screening on arrival, do you mean?

Citizenship and Immigration committee  I don't think people are going to immigrate to Canada in order to get screened for hepatitis B or C. I'm not sure I understand the question.

Citizenship and Immigration committee  We were not proposing that no pre-screening happens at all. Assuming that these people are screened to the extent that they are healthy individuals when they arrive here, they can still be healthy, for all intents and purposes, but some of them, and it's going to be a minority, may carry hepatitis B or hepatitis C viruses by virtue of the fact they come from countries of the world—East Asia and Southeast Asia being very prevalent places for hepatitis B, and other parts of the world having more hepatitis C than is found in Canada.

Citizenship and Immigration committee  Just to reinforce what I said, at the moment we don't screen for these conditions at all, so nobody gets screened. I don't propose that would change. At the moment, the inadmissibility on health grounds is about 0.3%. So at the moment we don't screen and we don't have people coming here.

Citizenship and Immigration committee  In my view, I would just focus on the infectious diseases, hepatitis B and C. While I think they're important, I would think it was more efficient to screen people when they arrive. If somebody is just hepatitis B positive or hepatitis C positive on screening, I would not exclude them, unless they had serious liver disease in the country of origin.

Citizenship and Immigration committee  I would not use hepatitis B and C as admissibility criteria at all. I would screen in Canada, and then what we do is we treat in Canada. So if somebody's a carrier of hepatitis B, we now have effective treatments. If they're not a carrier, if they're negative, then we can offer immunization, which, again, is a very effective way of making sure they don't become positive.

Citizenship and Immigration committee  Yes; it's three months before you can start.

Citizenship and Immigration committee  I don't know.

Citizenship and Immigration committee  I don't actually have any data on that. It took me three goes to get OHIP coverage, even when I was eligible, so....

Citizenship and Immigration committee  I would add that in addition, in the opposite direction, it shouldn't be repeated when the person is in Canada. The current regulation requires it to be done again when status changes, but that applies if the person's in Canada. That doesn't make any sense. So that recommendation could be dropped.

Citizenship and Immigration committee  Yes.

Citizenship and Immigration committee  Yes. That would be an ideal time to screen.

Citizenship and Immigration committee  I think it would be hard to require, because they may not exist. And it's not a requirement in the sense that you can't come here without them; it's more that if they're requested, people will do their best to bring them. Then, when they arrive, especially with kids, they can be caught up.

Citizenship and Immigration committee  TB, HIV, and syphilis are the three infectious diseases.