2016-Jun 10: Screening for tuberculosis – further x-ray certificate or testing required

Visa Pak 263 - Screening for tuberculosis – further x-ray certificate or testing required. Clarification on when staff should be waiving the requirement for this.

Visa Paks

10 June 2016

Screening for tuberculosis – further x-ray certificate or testing required


As per immigration instruction A4.25.1(e), applicants applying for a temporary entry visa who have been in a high risk tuberculosis (TB) incidence country* for six consecutive months since their previous chest x-ray certificate was issued, must provide a new chest x-ray certificate with their application.

It has come to our attention that some offices are waiving the requirement to provide a chest x-ray certificate as an exception to instructions (ETI), particularly for applicants that are deemed to be high value, such as Investor Category applicants wanting to travel to New Zealand before their residence application has been decided.

While the applicant may not be entitled to health funding under their temporary entry visa, TB is highly communicable and is expensive to treat. As such, the potential burden on the New Zealand health system is high.

Although an applicant may represent high value to New Zealand, this alone does not mitigate any risk factors associated with contracting TB. Waiving the need to provide an x-ray certificate solely on the basis that the applicant represents high value to New Zealand is not a true exception as the majority of skilled and investor migrants could be considered high value.

Even though the applicant may have provided an x-ray certificate with an earlier application, a subsequent x-ray certificate is still required by instructions. The previous chest x-ray may indicate there was no TB at that time; however, it does not mitigate the current health risk.

Therefore, the circumstances where it is appropriate to grant an ETI waiving the requirement to provide an x-ray certificate should be rare and the reasons for the true exception noted.

Where you are granting a waiver to provide an x-ray certificate you should consider issuing a short-term visa as an ETI and inform the applicant that if they apply for a further temporary entry visa they need to provide an x-ray certificate with that application.

*These are all countries that are not listed in A4.25.10 – Low TB incidence Countries, Areas and Territories.


Where a strong suspicion of TB is indicated by the Panel Physician

If a Panel Physician has ticked the “strong suspicion of TB” box on the clients chest x-ray this should act as a warning to the immigration officer (IO). The client will need to complete sputum’s and cultures which will take six to eight weeks to complete.

IOs should ensure this is completed and the Medical Assessor has provided an opinion before deciding the visa application. If an IO needs to make a decision on an application where the client has a strong suspicion of TB, and the medical assessment has not been completed, they should contact the Immigration Health Team at mailto:

INZ-HealthSupport@mbie.govt.nz, who can provide advice on what action to take on the application.

Panel Physicians will not indicate that there is a “strong suspicion of TB” without a good reason; therefore, this is a strong indicator that the client needs to undergo testing to exclude the disease. For onshore applicants, by sending a client for further tests onshore, Public Health Officials may be made aware of the case so they can put in place steps to minimise the impact to the community if TB is confirmed.

Action
Please discuss with your team(s).