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How Big is Too Big for New Zealand?

This past weekend New Zealand’s laws made an appearance in international news publications once again with headlines such as “South African Chef ‘Too Fat’ to Live in New Zealand” (BBC), “New Zealand Cites Obesity In Denying Chef’s Work Visa” (NPR), “Obese Man Faces Deportation” (Sky News), and “New Zealand Immigration Officials Say Man is Too Fat to Live There” (Toronto Sun).  Similar to the the stories about New Zealand’s baby name laws, these articles often show up in the “weird news” section.  So I thought I’d provide a bit of information about the relevant immigration rules – you can judge for yourself whether they are weird or not!

Under the Immigration Act 2009, the Minister of Immigration may certify “immigration instructions” relating to visas and visa conditions.  The relevant provision states the kind of matters that may constitute the instructions, including things like “any rules or criteria for determining the eligibility of a person for the grant of a visa of any class or type, or for entry permission, being rules or criteria relating to the circumstances of that person” and “any indicators, attributes, or other relevant information or matters that may or must be taken into account in assessing a person’s eligibility for a visa or entry permission.”  Furthermore, it states that any rules or criteria relating to eligibility may include matters relating to health, character, etc.

The immigration instructions are contained in the Immigration New Zealand Operational Manual which can be viewed online and is updated as new or amended instructions come into effect.  Health requirements are set out in section A4 of the Manual.  This includes a statement regarding the objectives of the health instructions, which are to:

a. protect public health in New Zealand; and

b. ensure that people entering New Zealand do not impose excessive costs and demands on New Zealand’s health and special education services; and

c. where applicable, ensure that applicants for entry to New Zealand are able to undertake the functions for which they have been granted entry.

The overview of the instructions in section A4.5 states that “[a]pplicants for residence class visas and applicants for temporary entry class visas are assessed to determine whether they have an acceptable standard of health using separate sets of criteria.  Assessment of whether a temporary entry class visa applicant has an acceptable standard of health takes into account their length of intended stay in New Zealand.”  Essentially, applicants may be required to submit a medical certificate from an approved panel physician in their current country of residence and then immigration officers determine whether the person meets the health requirements.  The determination process may include seeking advice from independent medical assessors in New Zealand.

The Operational Manual sets out what is required for an “acceptable level of health” for residence class visa applicants in section A4.10.  This section also explains the assessment of whether or not a person will impose “significant costs on New Zealand’s health services.”  It notes that “health services” includes all health and disability services provided through Vote Health – that is, New Zealand’s public health care system, under which foreign nationals may be eligible for services depending on their immigration status.

The Manual states that an applicant may fail the health requirements where, in the opinion of a medical assessor, there is a “relatively high probability” that a medical condition will require health services costing over NZ$41,000.  Section A4.70 of the Manual then sets out the factors to be used in determining whether a medical waiver should be granted to a particular applicant.

The Manual does not refer to a person’s weight or Body Mass Index (BMI) score as being a specific consideration.  However, the General Medical Certificate form used by Immigration New Zealand includes a place to specify an applicant’s BMI and the Handbook for Medical Examiners provides guidance to physicians on how to calculate this.  According to reports and Immigration New Zealand statements, people with a BMI score over 35 are not likely to meet the health requirements “due to the long term health risks associated with obesity.”

The articles about the South African chef are not the first to have reported people with high BMI scores being denied New Zealand visas.  In 2007, it was reported that a woman in the UK was denied a visa to join her husband in New Zealand because of her BMI score (the husband himself had previously lost weight in order to obtain a visa), and in 2009, there were reports that a doctor was denied a visa because of his size.

In the most recent case, it was reported that Immigration New Zealand had stated that the applicant (who is seeking a residence class visa) has “a chronic knee condition which needs surgery” and that there is also evidence that he has impaired glucose tolerance and an enlarged fatty liver, in addition to his weight putting him at risk of various conditions or diseases.  The agency’s spokesperson said that “[u]nless it is in the extreme, obesity will not in itself cause an applicant to fail health screening requirements.”  The applicant is now appealing the visa decision.

The reports could give rise to various questions, such as:  Is New Zealand the only country with this policy?  Do you think other countries will (or should) adopt this approach?  In what other policy areas might BMI be considered relevant?  I would love to hear what you think in the comments!

4 Comments

  1. Dwain
    July 31, 2013 at 10:48 am

    I believe that many countries should adopt this standard, not just for resident or working visas but also for immigrant status. As this country evolves into a government-subsidized, tax-payer funded health-care system, those people, at least initially, will not be contributiing substantially to the bank and will be a burden on our health-care system and more specifically, to the individual tax-payer. Should the immigrant or visa applicant post a $100,000 bond into health care, then perhaps a waiver could be granted. I believe this should also include active screening for visa or immigrant status to check for disease and substance use. My health insurance provider charges me extra for things like alchohol use, smoking and cholesterol; as a tax-payer paying for the social welfare program instituted by the current adminstration, I’m resistant to putting anyone new on the roles, even in a temporary status, if they’re not supporting the system. I think NZ is taking the right approach in denying visa status or renewing visa status, but not based solely on obesity, especially a number so biased as BMI.

  2. Grace Caruso
    July 31, 2013 at 12:37 pm

    Let’s not forget that this also says you can’t come into New Zeeland if you have extraordinary “special education” needs. Does this mean mental retardation, physical disabilities and Autism as it does in the US? Wow. Let’s hope none of the refugees they agreed to take form Australia have this kind of need……

  3. Kelly Buchanan
    July 31, 2013 at 12:47 pm

    That’s actually an interesting point about refugees. Section A4.60 of the Operational Manual states that “Applicants (and dependants included in their application) who have been recognised as having refugee or protection status will be granted medical waivers, unless (a) above applies.” (“(a”) relates to a person having certain serious needs, such as “a physical, intellectual, cognitive and/or sensory incapacity that requires full time care, including care in the community.”)

    Thanks for the comments!

  4. Sixto Gallardo, Jr.
    July 31, 2013 at 3:19 pm

    Let’s just pass a law and send them into outer space to just die since we are all just too Christian too care or can’t be bothered to take care our fellow immigrant…I think Hitler started at home first then spread-out…he called it living space. Maybe I am being to conservative, but it is the bottom line. Is it not?

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