Mind the language gap

The UK is a country where hundreds of different languages are spoken, with over 300 spoken in schools alone, and English, while certainly the language spoken by most people, is not everyone’s mother tongue. However, regardless of language, people still get sick and need to be treated in the NHS. Ensuring high quality patient care and positive health outcomes is at the forefront of the health sector’s aims, but without translation and interpreting services, this is not possible with a significant minority of the population.
Central to care
Effective communication is the heart of good medical practice. Whether patients are fluent in English, semi-fluent, or have never spoken the language at all, clear communication is essential. After all, clear communication can hold its challenges even when both parties speak fluent English, yet alone when there are issues of language barriers to consider. For those who do not speak the language, a medical interpreter is needed to ensure the patient is able to convey their symptoms, family history of medical problems, and any allergies to medication – all of which are vital in ensuring they receive the appropriate standard of care.
Without translation and interpreting services in the health sector, linguistic barriers would have a hugely detrimental impact on the quality of care that we are universally renowned to provide. On a daily basis, the NHS will see patients that are being treated for thousands of difficult and complex conditions. Those patients need accurate information, regardless of the language they speak, so that they have the appropriate information to make informed choices about treatments being offered, including fully understanding the risks involved.
Serving the entire population
Language access is an issue in every component of our society – be it health services, business or education – and we must address this need if we are to provide a service of the highest possible quality. Inaccurate communication can have dire consequences in any sector, but in the health sector, it could potentially be putting a patient’s life at risk and could open the NHS up to legal claims against it. Having a basic understanding of the language may be sufficient in everyday life, but in a medical setting, simple differences in communication are critical. Patient care and patient outcomes suffer tremendously when communication between the patient and the doctor is hampered. From both the patients’ point of view and from those delivering the health services, it is in their best interests to be able to communicate accurately and effectively to provide the best possible health outcomes – and to do so, professionally delivered interpreting and translation services are essential.
Weekly headlines highlight the tight budgets in the NHS and a world where every penny counts sometimes results in reductions to translation and interpreting services. However, these services should not be deemed an addition or a luxury to the NHS – in fact, only those who speak English fluently would ever suggest such a viewpoint.
Translation services in the NHS convey information and ensure the wellbeing of all patients and professionals. Healthcare professionals in the NHS are there to meet the needs of the patient, and this needs also to include their linguistic requirements. Language services bridge this gap and ensure patients understand the treatments that are being offered, so that they are confident on the issues and potential risks. When people have to make choices about their medication, or potential surgery, it isn’t possible for them to make those decisions unless they have accurate information – and this is of course impossible without the information spoken in a language they understand.
Professional skills
The service that the NHS provides also encompasses the support and care that is vital to anyone suffering from any kind of illness. According to the 2011 National Census published by the Office for National Statistics, 7.7 per cent of the population speak a first language that is not English – some 4.2 million – and while most of them have good command of English, the same statistics show that nearly 140,000 cannot speak the language at all. This means that it is essential for the NHS to have access to translation and interpreting services to deliver safe healthcare, whether this is in a primary or secondary healthcare setting.
Apart from ensuring the availability of language services in the NHS, it is also essential that hospitals and GP surgeries are accessing language services that are of the highest quality to ensure that the translations are delivered professionally and with full regard to patient confidentiality.

Unfortunately, it is not unheard of for some – where they don’t have access to translation services – to bring in someone outside of the profession in to help translate the doctor’s message. This person may be sweeping the floors outside a doctor’s office, for instance, but is the only candidate available who holds the necessary language skill and is therefore deemed suitable to translate sensitive and private matters regarding the patient’s health.
This person is not a professional translator or interpreter and this custom is therefore not only unprofessional and bad practice, but also puts into question the confidentiality between the patient and the doctor. If interpreting services within the NHS were not easily available, as they are today, it would not be surprising to see more hospitals reaching for these types of solutions.
Many members of the Association of Translation Companies provide language services either directly to local trusts or as part of national framework agreement in England. These services can be delivered either via face-to-face and over the telephone. They work to the highest professional standards and will provide information in a form convenient for the patient. For instance many will need their treatment options addressed in written form to allow them to discuss their options at a separate time with their families.
It is crucial that the NHS works with those who are appropriately qualified, so that patients and doctors can be confident that they understand the boundaries within which they are working. For instance, there are some ATC that specialise in telephone interpreting services that are accessed during doctor and patient consultations. In such situations the interpreter acts as the relevant intermediary, to ensure all parties understand each other and no element of the consultation is open to misinterpretation. Working without such standards not only risks the reputation of the NHS service, but also of the language service industry.
A human rights issue
In 2013 a total of £22.7 billion – nearly a fifth of the NHS annual budget – had to be set aside to pay compensation to thousands of people harmed by poor care. If something goes wrong, for any reason, including issues that can be traced back to the provision poor language services, the patient could then argue that they weren’t properly informed which could lead to claim on the NHS.

There are some basic human rights issues involved in this whole question too. Every UK citizen is entitled to access NHS services, regardless of their language ability or preferences, and therefore they should be entitled to fully understand the diagnosis of their condition, what treatments are being offered to them, and what the implications are. Without this knowledge, people will be anxious of accessing the health service in the first place – and conditions further down the line can become more expensive and complex to treat.
The basic issue of allowing patients to be fully informed is something that could change their lives, and this human right is something that is so fundamental to a modern society. You only have to think about how many Brits encounter health problems when travelling abroad. They would expect foreign health professionals to communicate in English with them, and yet this is simply a case of tourism and short visits, in comparison to those who live permanently in the country. Many immigrants in this country are elderly, and may not have a full grasp of the English language, but they are entitled to use NHS services – but without translation and interpreting services, we simply would not be able to provide an effective means of treatment for them.

Further information