Quebec docs report rise in baby tourism but furious when foreigners skip on bill
The Canadian Press
Mar 8, 2009
MONTREAL Neither Ottawa nor Quebec has immediate plans to address complaints from Quebec doctors who cite a rise in maternity tourism, a situation considered problematic when foreigners default on their financial obligations.
Several Montreal hospitals have noticed an increase in the number of pregnant foreign women, predominantly from French-speaking countries, who travel to Canada to give birth, according to the Quebec Federation of Medical Specialists.
Citizenship and Immigration Canada says any person born in Canada who isn't a child of a diplomat becomes a citizen at birth.
While anecdotal figures from Ste-Justine Hospital, St-Mary's Hospital and St-Luc Hospital suggest upwards of 125 foreigners delivered babies in the city last year, complete statistics were not available.
Figures obtained by The Canadian Press from the Canadian Institute for Health Information, however, shed some light on a practice that's raising questions about Canada's citizenship policies.
In 2005-2006, the only year Quebec statistics were available, the province delivered 273 babies to foreign mothers, compared with just 169 in the rest of the country.
Ontario had the second highest number of infants born to non-Canadian residents with 91, followed by British Columbia with 35, Alberta with 15, Manitoba with 11 and Newfoundland with 10. The figures for other provinces were not made public for privacy reasons.
Though Quebec numbers were not available for the following two years, the rest of Canada experienced a significant increase in 2006-07 – 218 compared with the 169 a year earlier.
Still, those figures dropped in 2007-2008 to 178, making it difficult to assess whether the problem is getting worse.
Citizenship and Immigration Canada spokesman Nicolas Fortier said all foreign nationals visiting Canada must show they have sufficient funds to support themselves and their dependants while in the country.
“In the case of a woman planning to give birth in Canada, this would include associated costs,” he said.
But therein lies the issue, according to Gaetan Barrette of the Quebec Federation of Medical Specialists.
What Quebec doctors are upset about is that some foreign women are skipping out on their hospital bills.
As with any emergency service, salaried staff don't lose out if a patient can't pay, Barrette argued, adding each labour and delivery costs the health-care system between $5,000 and $7,000.
Doctors, however, are self-employed and lose about $400 each time a pregnant foreigner doesn't pay.
“The objective to us is not to start a witch-hunt,” he said. “The issue for us is to get proper compensation because we think we are treated unfairly.”
He's calling on the Quebec government to pick up the tab when doctors provide emergency labour and delivery services to foreigners who don't pay.
In the meantime, he's encouraging physicians to refuse to sign declaration of birth forms for mothers who skip the bill – something some doctors have already done.
Marie-Eve Bedard, a spokeswoman for Quebec Health Minister Yves Bolduc, said hospitals are responsible for recouping costs for care and that it's up to them to do so on behalf of their doctors.
Still, while non-payments ultimately come out of the hospital's budgets and do represent a loss, she said they're minimal.
“You need to understand what it represents for the Ministry of Health and Social Services,” she said.
“When you look at it in terms of the amount you can lose in a year with respect to unpaid bills, it represents 0.08 per cent.”
Melanie Dallaire, a spokeswoman for Ste-Justine Hospital, also cautions that it's just a small portion of foreign women who don't pay.
In 2006-2007, for example, non payments amounted to $60,016 – “a nurse's salary,” she said, adding it still represents just 0.02 per cent of the hospital's total budget.
“It happens but it's not something that happens regularly,” she said. “We are able to recover a large part of the money they owe.”
In a recent radio interview, Citizenship and Immigration Canada Minister Jason Kenney admitted maternity tourism was an issue he had only just learned about.
He said he's asked his staff to report back with numbers before he decides whether to act. Changing Canada's policy, he said, will depend on how widespread the practice is.
According to provincial health departments and national physician groups – a number of which had never even heard of the practice – maternity tourism is not much of an issue.
Dr. Vyta Senikas of the Society of Obstetricians and Gynecologists of Canada said it has yet to raise any “red flags” with her organization.
“I can honestly tell you, it's not been a big issue on the radar at all,” she said. “We at SOGC have no reason to believe it's a systemic problem.”
The issue also failed to strike a chord with provincial health officials in Alberta, Saskatchewan, Nova Scotia and Prince Edward Island.
B.C. officials said maternity tourism hasn't raised many eyebrows, but the issue surfaced last month when an infant was rushed to hospital with a suspected case of shaken baby syndrome. It was learned the girl's parents came to B.C. so their daughter could be born Canadian.
A 2005 case in which the daughter and daughter-in-law of a Syrian general were issued tourist visas so they could give birth in Canada also drew national attention.