Immigration declines residency visa for family of much-needed Wairoa nurse

A family has been denied New Zealand residency on the grounds their daughter is a medical burden to the country.

Immigration New Zealand determined their eldest daughter does not meet the Acceptable Standard of Health, despite the fact she only requires one tablet a day to treat her Marfan syndrome and four independent doctors deemed her condition to be low risk and low cost to the medical system.

The mother, Jeena Jose, moved to New Zealand in 2019 after being granted a Skilled Migrant Resident Visa and worked through the Covid-19 pandemic as a registered nurse in Wairoa. She is now a permanent resident.

Her partner, Jino George, and their two daughters, Meryl and Nora, applied for residence under the family category based on Jose’s residence visa when they arrived in March 2020.

However, in September 2021, the family’s resident visa was declined on the basis Meryl did not meet the country’s minimum health standard.

“I was shocked,” Jose said.

The family appealed the decision and provided statements and reports from four independent doctors, refuting Meryl would be a burden to the system.

They spent about $20,000 travelling to Auckland to meet with numerous specialists to satisfy immigration requirements. However, their appeal was unsuccessful.

Wairoa Hospital has also written to the minister, imploring her to grant Meryl a visa so her mother could stay because they are desperate for staff, and she is the only trained ICU nurse at the hospital.

As part of the residence visa process, a medical assessor appointed by INZ determines whether there is a relatively high probability that a health condition will require services costing in excess of $41,000 within a period of five years.

But in the three years Meryl has lived here, she has not had any hospital admissions or adverse effects from her condition and no doctors’ visits – apart from what was required for the immigration application.

“She is healthy. She can communicate, she is bilingual, and doctors say she can play sport,” Jose said.

As Meryl was not initially included in her mother’s original application for residence, she cannot be granted a medical waiver.

Fisher Foley senior associate Ana Martins, who advocated for the family, said that was simply an oversight on Jose’s part, because she had not been assisted by a lawyer during her application for residence.

“She’s a lay applicant, she’s not legally trained. She wouldn’t know she was required to include her daughter in order to get a medical waiver later, if needed,” Martins said.

Advocates plead for ministerial intervention

Immigration expert David Fisher said common sense and compassion was required in this case.

“Although the family may not meet the technical requirements for the visa, the immigration system is designed to allow for discretion where common sense clearly shows that New Zealand would benefit from an applicant being granted residence.”

Jose never anticipated Meryl would not meet the minimum standard of health, Fisher said.

Immigration New Zealand also recently increased the threshold on probable costs for medical conditions from $41,000 to $81,000 – a figure which Meryl’s costs come well under, according to doctors the family spoke to.

“We tried to make a second request to the minister after the threshold was raised, but she unfortunately decided not to intervene,” Martins said.

Fisher said he had been stunned by the continual rejections.

“This rejection from the minister appears to be inconsistent with previous decisions, he said.

“We went to the Immigration and Protection Tribunal with confidence, we felt that regardless of any medical costs, this family is needed by the local community.”

With Wairoa Hospital, the community, and the local MP behind them, Fisher questioned whether the outgoing minister cared and if the incoming minister was too busy.

“I wonder if they have fallen victim to a government in disarray.”

Martins was similarly bemused as to why the minister would not intervene.

“In past cases, we have always been heard. We don’t understand why both associate ministers decided not to intervene.”

Any cost associated with Meryl’s condition was more than offset by Jose’s work, Martins said.

Daughters desperate to return: ‘They miss their school, they miss their friends’

In the meantime, Meryl and Nora are staying with their grandparents back in India, awaiting word on if they can return home.

Compounding matters, her husband is now blind following a botched operation to treat his glaucoma in Wellington.

“[Meryl and Nora] are desperate to get back, every day they call, they just want to get back, they miss their school, they miss their friends, and they are worried about their dad. It’s really hard,” Jose said.

She was worried her husband would not receive any medical support back in India.

“My husband is learning how to walk, and getting support for his treatment from ACC.”

It was insult to injury for the family that after the medical misadventure, the government was turning its back on them, Jose said.

“This is a suitable place for us now, we won’t get that support back home, this is the best place for us.”

Her spirit had been severely tested throughout the ordeal, she said.

“I need to look after my family, if I live in New Zealand, I can do that, this is an amazing community and I want to continue to serve this country.”

It was all taking an emotional toll, she said.

“It’s really stressful, we only have one more month to make a plan.”

Fisher said it was important New Zealanders knew what they were losing.

“We want the public to know we are going to lose a highly qualified nurse that both the town and the country desperately need.”

Immigration explains decision, disagrees on medical costs

Immigration New Zealand (INZ) border and visa operations acting general manager Michael Carley said the overriding issue of concern might not be the cost of services required but the need for services and resources.

“During processing, it was determined that their daughter did not meet the requirements to be of an Acceptable Standard of Health (ASH), on the basis that she was likely to impose significant costs or demands on the New Zealand health system.”

INZ’s medical assessor noted Meryl had chronic recurring medical conditions likely to impose costs exceeding the threshold of $41,000, Carley said.

“We sought an opinion from a different medical assessor to ensure a fair assessment, and this came back with the same overall concern.”

RNZ has seen statements from two paediatric cardiologists, two otolaryngologists and a GP differing from INZ’s medical opinion.

All five statements indicate Meryl would most likely come well under the $41,000 threshold for medical costs and that any surgery would not be required until her teenage years at the earliest.

Martins said there had been no clarity provided by INZ.

“There is no clear reason why the four private doctors’ opinions are not valid.”

Carley said the fact Jose was a nurse was not able to be considered when the decision was made.

“INZ does not have the ability to apply discretion when assessing residence visa applications.”

However, Martins said the minister did have absolute discretion to grant any visas to any applicants at any time.

RNZ has approached the minister for comment but they did not respond to requests.

Fisher believed Jose’s situation was a clear-cut case for humanitarian compassion.

“If you weigh it up against the benefit Jeena brings to the health system, we are just flabbergasted.”

Support from Wairoa community

The family had the support of the entire Wairoa community, Fisher said.

“We have always struggled gaining skilled labour and here we have a family willing to contribute to the heartland of New Zealand and, seemingly for no reason, the government wants to get rid of them.”

Staff at Wairoa Hospital had also written on behalf of the family to INZ.

They said the family were active, well respected and held in great regard and mana by the people of the whenua.

One said losing Jose would significantly impact the local vulnerable community and be in direct violation of the minister’s promise to improve health outcomes for Māori.

Members of Te Whatu Ora also wrote to the minister urging them to reconsider as they say Wairoa has a critically low number of nurses.