Breaking the language barrier

Highlighted in its core principles, the NHS sets out to be “responsive to the needs of different groups and individuals within society”. To this end, there will always be a need for some form of translation and interpreting services in the NHS to accommodate today’s multi-cultural society. But the issue does not just end there; the quality of the translation is also vital. Any inaccuracies caused by a poor translation in the health sector could, quite literally, result in life or death.

Risky business
Health professionals need to hear an account of their patients’ illness and medical history in order to make a decision about treatment. If this is not obtained, it could result in failure to identify conditions and failure to take the necessary action.
    
By having no or a poor quality interpretation service, health professionals may be forced to compromise or lower their standards by treating patients without explanation or discussion. In addition, it is stressful having to perform examinations or treatments on a patient that is distressed because he or she does not understand the situation.

Which translation service?
There are various different types of translation and interpreting services available to the sector, but how do you know which is the most appropriate for the situation?
    
The decision about whether to use a face-to-face interpreter should be judged on a case-by-case basis. As a basic rule, the more complex the communication, the more likely the need for face-to-face interpreting. Likewise, if the interview is going to be long, if the patient is vulnerable or if sensitive information or bad news is going to be disclosed.
    
An alternative service is telephone interpreting where the interpreter is at the other end of the line. The call is connected like a conference call between the patient, health professional and interpreter. This should be utilised when short but important pieces of information need to be communicated immediately. The charges are usually based on the time spent on the call.
    
Written text that needs communicating to the patient, such as a patient record, leaflet, brochure, website content, e-mail, letter or form, will need text-to-text translation in the required language.
    
Alternatively, some suppliers offer text-to-speech translation. This is where a document is communicated to the health professional or patient orally or by audio in the relevant language. It can be a good option for the visually impaired or illiterate. One method is to send the document to the translation agency with the language required and the relevant telephone number. An interpreter will then call the patient to read the content of the document into the required language. Alternatively, the supplier may be able to supply the text as audio.

Cultural understanding
Another service which is useful in today’s multi-cultural environment is ‘cultural understanding’. This is where minority groups give feedback on the cultural sensitivity of a document and highlight any issues that might arise due to cultural differences.
    
In addition to those affected by language or cultural barriers, the deaf community should also have access to an interpretation service. British Sign Language interpreting and lipspeaking allows medical professionals to communicate with members of the public who are deaf or hard-of-hearing.
    
Sign Language interpreters take spoken words and convert them into hand and body movements. Lipspeakers on the other hand are trained to transfer the spoken word into lip movements that deaf people can understand.
    
Whichever translation service you use, it is extremely important to make sure that the supplier can offer quality translation and interpreting services for the specific needs of the health sector. Knowing a foreign language alone is simply not enough in the medical profession. The meaning of a text or speech must be understood before it can be translated and if the text or speech is full of medical terms and jargon, then it is unlikely that a translator without medical knowledge and experience will be able to do a sufficient job.
    
Suppliers that are members of professional bodies such as the Institute of Translation and Interpreting (ITI) have to adhere to a strict code of professional conduct and can be a good place to start your search.

The cost of translation
It was reported earlier this year in the Sun newspaper that health chiefs are spending £22 million a year on translators, with the cost of interpreters pushing the total NHS translation bill to an estimated £55 million a year. Polish, Turkish, Farsi, Kurdish, Mandarin, Somali, Arabic and Bengali are the most commonly demanded languages.
    
When you think how much extra frontline staff you could hire with such money, it is understandable that translation in the NHS is a contentious issue. In fact, some argue that by providing translation services so readily to foreigners, it works as a disincentive for them to learn English.
    
However, the opposing view is that translation allows immigrants to gain access to services while they learn English and helps ease them into British society. It is unlikely that an immigrant will learn English immediately upon arrival and even more unlikely that they will learn it before they arrive in the UK as the majority will not have access to language learning resources. With this in mind, the translation of certain services will help the non-English speaking communities with the transition into British society.
    
The debate also overlooks the fact that not using qualified translators can be far more damaging in terms of errors and can actually end up costing far more in terms of money, time caused by diagnostic delays and problems.
    
There will always be new arrivals to this country with varying levels of English. There will also always be tourists. So even if all permanent residents learnt English, there will always be a need translation and interpreting in the health sector.
    
Given that accurate communication is crucial to situations concerning health, it is extremely important that the translation and interpreting services available are of the best quality and tailored to the precise needs of the medical profession.