HL Deb 27 July 1999 vol 604 cc1387-90

2.50 p.m.

Baroness David asked Her Majesty's Government:

What progress there has been with the employment of qualified interpreters in the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman)

My Lords, the National Health Service provides a range of interpreting services in the many and varied settings in which healthcare is delivered. Interpreting services are provided on both a planned and emergency basis to support the delivery of effective and culturally-sensitive healthcare. The NHS is committed to addressing communication barriers that prevent black and ethnic minority patients from receiving the care and treatment which they need.

Baroness David

My Lords, I thank the Minister for her reply. The aims are clearly excellent. I should like to know why lower standards are accepted for translation and interpreting in the health service than in the criminal justice system where there is an agreement that, by the year 2001, all the interpreters in all sections of the criminal justice system will be members of the national register of public service interpreters.

Baroness Hayman

My Lords, I am not sure whether it is lower standards or different challenges that we face in the health service. This year, for the first time, the formula used to inform allocations to health authorities included an English language difficulties adjustment of £10.9 million. That was to reflect the extra costs of providing interpretation, advocacy and translation services to ethnic minority patients who experience difficulties with the English language. I believe it important that we recognise the variety of situations in which healthcare is delivered and the need not only to deal with simple issues of speaking a different language but to make sure that services are accessible to communities who may not easily gain access to them.

Lord Clement-Jones

My Lords, it is not very clear exactly what the Minister is saying. Does the department acknowledge the value of the use of trained interpreters and has it commissioned a report into the use of those interpreters, which I believe to be the case? Does it have any intention at all of following the excellent example of the criminal justice service?

Baroness Hayman

My Lords, I should not like in any way to devalue the work which has been done in the criminal justice service. Indeed, some of the training utilised by health authorities is the same as that for interpreters within that service. The noble Lord is right that a piece of work is being carried out at the moment, undertaken by the King's Fund, to map in London a comprehensive picture of the provision both of health advocacy link work and interpreting services. As I said, I think the issue is broader than that of simple interpreting. The report will cover all the Greater London NHS trusts and health authorities as well as voluntary organisations representing the minority ethnic and refugee communities in the capital.

Lord Laming

My Lords, the National Health Service is no more immune from racism than any other organisation; and I include every organisation with which I am associated. What steps are being taken to ensure that all patients and staff are treated with equal respect?

Baroness Hayman

My Lords, the noble Lord rightly points out the two different strands of work that we have to undertake. We have to provide equal opportunities for staff within the NHS. We have launched a national plan of action about tackling racial harassment in the NHS, and through the positively diverse programme we are engaged in a service-wide policy of encouraging recruitment and development of staff from local communities.

We also have to consider the provision of services which are sensitive to the needs of minority groups. For example, as regards the uptake of screening programmes it is important to have locally-based services within communities which have the best insight into how to encourage women, in the example I give, to take up the services available.

Baroness Gardner of Parkes

My Lords, the Minister says that about £10 million is being devoted to this issue. In order to achieve better value, has consideration been given to encouraging interpreters also to act as health assistants and to seeking volunteers from the community groups to which the noble Baroness referred? The National Health Service is desperately in need of every penny it can obtain.

Baroness Hayman

My Lords, some schemes are based on using volunteers. It is important to recognise the need to ensure confidentiality and standards. I believe that that motivation lay behind some of the questions about training. Volunteers must be properly trained and equipped. None of us wants volunteers to be the small children who interpret for parents. There is an area of work there. Traditionally, the NHS has used staff who speak other languages to interpret in emergency situations. Again, we need provision for standards. However, in the employment of link workers and patient advocates, people can take on a dual role rather than simply interpreting.

Lord Ashley of Stoke

My Lords, the needs of deaf people who require sign language are just as great as those who are black, from ethnic groups, or who depend on foreign languages. Perhaps I may make a declaration of a non-pecuniary interest. I am the president of the Royal National Institute for the Deaf (RNID). Although the Minister's initial Answer about the provision sounded marvellous, in fact it is not that marvellous. The RNID recently conducted a survey of doctors' surgeries. It found that 39 per cent of individuals had to rely for interpretation on families and friends; and when they left the surgery 37 per cent did not know the diagnosis or treatment. Does the Minister agree that the health service should ensure that all patients—deaf, black, ethnic, foreign, or whoever—should be told clearly the diagnosis and treatment?

Baroness Hayman

My Lords, my noble friend rightly points out that the barriers to receiving high quality care are not simply those of speaking a foreign language. When we consider health inequalities, we realise that a number of factors—they may involve speaking or hearing language, or socio-economic deprivation—may stop people receiving services. That is why work in health action zones and health improvement programmes is important.

I am not sure that I said everything was marvellous. I said that we sought to make progress in this area. There are some innovative schemes. In one of the beacon sites recently commended, which involved primary care, a telephone link with a hand-free conference facility is being used where the patients of a GP speak many different languages. It has been well received by both professionals and patients.

Baroness Uddin

My Lords, does the Minister agree that employment of advocates and interpreters was a short-term replacement for the employment of bilingual workers across the health service? Can some of the good practices in areas such as Tower Hamlets and Newham be examined? Some interpreters have had the opportunity of NVQ experience, a factor which might address the Question asked by my noble friend Lady David.

Baroness Hayman

My Lords, yes, we can learn from, and spread examples of, good practice. The King's Fund exercise will help us to do that.