Catherine Park, Institute of Translation and Interpreting, looks at the impact and benefits of multilingual policies in hospital including translating visiting hours, evacuation plans and signs

Globalisation has contributed towards rapid growth in the translation and interpreting sector. The world has been getting smaller in terms of our need and desire to visit other countries and communicate in other languages, and that has led to an increased demand for the services of professional translators and interpreters. Worldwide, this sector is said to be growing at a rate of 5.52 per cent per annum.

This demand is reflected in the UK health sector, where the nationality of patients being treated has become very diverse for a variety of reasons – including increased foreign travel for holiday or business, ‘health tourism’ where people choose to have a medical procedure overseas, and significant representation of different nationalities in particular communities.

Material that may need to be translated in the UK includes patient information leaflets, website copy, medical notes, documents that a patient has brought with them relating to their health or medication they have been taking. Where a healthcare provider has a strong representation in their area from particular language-speaking communities, they may have an extensive collection of translated material readily available for these groups.

The typical role of an interpreter would be facilitating face-to-face consultation between a doctor, patient and/or family, or a phone consultation. This could range from quite routine conversations to obtaining and conveying information in more urgent medical situations. While there is a clear desire and obligation to communicate effectively with all patients, certain factors mean that this is not always entirely straightforward. Concerns are commonly expressed about where money is being allocated when funds are limited, and periodically national and local newspaper articles highlight the amount being spent on translation and interpreting in a particular hospital or area – along with the attendant criticism from politicians and influencers.

Another view sometimes expressed is that too much translation is not helpful in relation to people integrating into their communities, and that it may be more beneficial to give more attention to producing information in simple, plain English.

It is perhaps not surprising, therefore, that approaches may differ significantly from one healthcare provider to another. In 2020health’s research report, Lost in Translation, some responding NHS trusts said they did not translate into any other languages, while some translated into as many as 120, with most saying between five and 25.

There are some indications that the amount of written translation work being commissioned by hospitals has been going down, while the amount of interpreting work has been going up. One reason why written translation may have reduced is that some information is available centrally (through government, health service or other sources such as charities in relation to particular conditions) or that something similar has been produced in the organisation previously, and there are more policies and guidance relating to when new translation is appropriate.

Working conditions
The financial situation has impacted the relationship between language professionals and healthcare providers in other ways. Over ten years ago, it was probably quite common for interpreters to be directly employed by a healthcare provider. In the light of greater demand for interpreters than ever before, coupled with a drive to cut costs, there has been a tendency to withdraw direct involvement with interpreters and to outsource to private agencies through procurement.

These private companies will feel the pressure to keep prices down – and sometimes unrealistically so. This is then passed onto the freelancers who they employ to do the work. This can lead to poor pay, both in terms of hourly rate and in relation to the conditions they must accept to be employed.

ITI has anecdotal evidence that highly-qualified individuals are sometimes opting to move to other areas where pay will be more in line with their skills and experience, for example clinical trials or pharmaceuticals. The danger is that this will lead to an influx of less qualified and unexperienced interpreters willing to provide services at lower prices and for worse contract conditions.

Technology
Technology is sometimes heralded as a way to cut costs and time, while still maintaining standards. There is much publicity about Google Translate and similar tools and how they are becoming ever-more reliable and sophisticated. This needs to be viewed with quite a bit of caution. If you just need to get the gist of something, or to double check a spelling, then Google Translate may be fine.

It should certainly not be used for important information that needs to be shared with others to give them a completely accurate understanding of something. The most dangerous aspect of this is if such a tool comes back with quite a plausible, but ultimately wrong, translation. Because how are you going to know?

Professional translators do use specialist translation tools to hasten and aid the accuracy of their work. These typically store terminology and phrases that they have input previously, so the translator can identify these quickly in new text, thereby saving time. Similar phrases are known as ‘fuzzies’, but just as in the example above of the plausible translation in Google Translate, there could actually be quite a different meaning despite the apparent similarity. A professional translator is needed to make an accurate assessment and an appropriate decision in relation to what the technology is presenting. Machine translation will continue to improve, but it will be a long time before it comes close to being able to deal with context in the way that only a human translator can.

Improving and maintaining skills
Language professionals need to keep developing their skills – it is not enough to be excellent at one or more languages (although this, in itself, is a life’s work!). Remaining up to date with translation technology developments will be important for them in continuing to meet the needs of clients in terms of speed and quality of delivery.

Medicine is a fast-evolving field and so is the terminology. Where pharmaceuticals were once largely about synthetic chemistry, in recent years we have seen the advent of many biotech products. In surgery, new treatment techniques such as robotics have brought quite technical terminology into the sphere of the medical translator and interpreter. Medical translators and interpreters rarely have a scientific or medical background, so considerable effort has to be expended by them in order to be familiar with the terminology used and the circumstances encountered.

On the plus side for linguists trying to keep up with terminology, a wealth of online data – such as textbooks and specialist mono- and multilingual websites – is now at their fingertips. In addition, awareness of research findings can be useful to both clients and language professionals in refining their relationship and the way the service is offered to patients. In the past, interpreting research tended to be about language processing and bilingualism, but much more work is now taking place examining interpreting in a particular workplace context. The British Psychological Society has just produced guidelines for psychologists working with interpreters, based on extensive desk research (November 2017).

In relation to translation, much research has been focused on getting the most out of machine translation, and ensuring that human translators and technology work as effectively as possible together. This includes Portsmouth University’s recent report: When Translation Meets Technologies: Language service providers in the digital age.

The Institute of Translation and Interpreting (ITI) believes that continuing to upskill and enhance knowledge is essential for any professional translator and interpreter. The Institute has a full continuing professional development programme, and a progression of membership categories based on levels of qualification and experience. Qualified members appear in the Institute’s public register on its website.

ITI’s Medical & Pharmaceutical Network supports translators and interpreters in keeping up to date with the latest developments through workshops, a newsletter, an online forum and an extensive archive of previous questions and answers from linguists specialising in work with the medical sector, as well as comprehensive lists of medical abbreviations and useful and trustworthy websites.

Brexit
We started the article with the steady march of globalisation, but will coming out of the EU put the UK in reverse? This seems unlikely, but in relation to the precise impacts of Brexit, it still is a question of – wait and see. The main concern for European citizens living in the UK has been clarifying what they need to do to ensure they retain residency status. It is still a fluid situation but, at time of writing, the first phase negotiated agreement means that EU citizens residing in the UK on the date the UK leaves the EU (currently expected to be 29 March 2019) will be able to remain indefinitely.

Language specialists leaving the UK in significant numbers would be detrimental, because it is important that suitably qualified people are available to translate into their own language to provide the best possible service to clients. It does not appear that there will be a mass exodus of translators and interpreters in the short to medium term, but it is unclear how things will evolve further down the line.