The federal government has examined setting limits on the number of refugees that Canada takes in with health problems such as trauma from torture.
Staff at Citizenship and Immigration Canada were asked last year to suggest ways to cut down on the number of "high needs" refugees to reduce strain on the health-care system, according to documents obtained by The Canadian Press.
That request came from former immigration minister Jason Kenney, who is still the Conservatives' minister responsible for multiculturalism.
He was eventually given options that included a cap on refugees with health problems – such as "developmental delay, blindness, victims of trauma and torture" – allowed from within a specific population group, according to one memo.
There were concerns such a change might create a public-relations problem. Canadians might consider it an abdication of the country's efforts to help the world's most vulnerable, the 2012 memo said.
"Implementing quotas for refugees with these needs could be perceived as a reversal of Canada's humanitarian tradition," said the memo, signed last Dec. 11 by a top official in the immigration department, Neil Yeates. "Vulnerable refugees would be disproportionately affected, as vulnerability within refugee populations is often tied to health and mobility issues."
Another option suggested was to work with the United Nations High Commissioner for Refugees to change the definition of a "medical case referral" to curb the number of refugee arrivals with "serious medical needs."
Those proposals are coming to light during a major overhaul of Canada's refugee policies, affecting everything from which refugees the country accepts to how claims are processed.
Starting in 2013-14, Ottawa will shift away from a global resettlement program to focus on between three and five specific refugee populations.
The Conservatives have, meanwhile, faced criticism for last year's cuts to health services provided to refugees and refugee claimants. Doctors and refugee advocates argue that the move is short-sighted and puts the most vulnerable at risk.
The cost of the refugee health-care program had climbed to $82.9-million in 2011-12, from $48.3-million in 2006-07, Citizenship and Immigration statistics show.
It is unclear whether the idea of health quotas remains under consideration.
Mr. Kenney was advised to give a response by Jan. 2, 2013, to the memo, which is heavily redacted. Chris Alexander took over Mr. Kenney's ministerial post in the July cabinet shuffle.
A spokeswoman at Citizenship and Immigration, Andrea Khanjin, would neither confirm nor deny whether the federal government had chosen to pursue one of the options laid out in the memo.
"I can tell you that our Conservative government will continue to give refuge to the most vulnerable populations," Ms. Khanjin said in an e-mail. "Canada welcomes one out of every 10 refugees resettled around the world, more than almost any other country in the world."
The memo says Canada accepts 10 per cent of all medical cases referred by the United Nations High Commissioner for Refugees – more than any country except the United States.
That memo is one in a series prepared for Mr. Kenney that propose changes to ensure refugees selected to live in Canada are healthier and more easily integrated, and allow for efficient processing.
The new approach is a drastic shift – away from responding to the needs of refugees toward more self-serving aims, one refugee advocacy group said.
Economic benefits and cost-cutting are getting priority over the humanitarian concerns of the world's most vulnerable, said Janet Dench, executive director of the Canadian Council for Refugees.
"What we seem to be seeing is that everything is being subsumed under the overall objective of serving Canada's economic needs," she said in an interview. "They're evaluating refugees on the basis of which ones are going to be best for Canada's economy."
According to the memo, Mr. Kenney had asked the department to come up with a way to manage the number of refugees arriving with health problems as part of a "larger strategy to improve refugee outcomes."
Another factor apparently is influencing Canada's refugee efforts: federal foreign-policy goals.
A proposal to resettle 5,000 refugees out of Ankara would complement "Canada's efforts to build a bilateral relationship with Turkey," said a memo dated Oct. 30, 2012.
The same memo shows that Ottawa's move to narrow its focus to three to five populations went against the wishes of the UNHCR, which manages refugees internationally.
"UNHCR would prefer Canada not move away from its global approach," the document said.