Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members?
Ben Gray A C , Jo Hilder A and Hannah Donaldson B
+ Author Affiliations
- Author Affiliations
A Department of Primary Health Care and General Practice, Wellington School of Medicine and Health Sciences, PO Box 7343, Wellington South, University of Otago, Wellington 6021, New Zealand.
B Porirua Union and Community Health Service Inc, 221 Bedford Street, Cannons Creek, Porirua 5024, New Zealand.
C Corresponding author. Email: ben.gray@otago.ac.nz
Australian Journal of Primary Health 17(3) 240-249 https://doi.org/10.1071/PY10075
Submitted: 15 October 2010 Accepted: 24 February 2011 Published: 5 September 2011
Abstract
Australia and New Zealand both have large populations of people with limited English proficiency (LEP). Australia’s free telephone interpreter service, which is also used by New Zealand through Language Line (LL) but at a cost to the practices, is underused in both countries. Interpreter guidelines warn against the use of family members, yet the lack of uptake of interpreter services must mean that they are still often used. This paper reviews the literature on medical interpreter use and reports the results of a week-long audit of interpreted consultations in an urban New Zealand primary health centre with a high proportion of refugee and migrant patients. The centre’s (annualised) tally of professionally interpreted consultations was three times more than that of LL consultations by all other NZ practices put together. Despite this relatively high usage, 49% of all interpreted consultations used untrained interpreters (mostly family), with more used in ‘on-the-day’ (OTD) clinics. Clinicians rated such interpreters as working well 88% of the time in the OTD consultations, and 36% of the time in booked consultations. An in-house interpreter (28% of consultations) was rated as working well 100% of the time. Telephone interpreters (21% of consultations) received mixed ratings. The use of trained interpreters is woefully inadequate and needs to be vigorously promoted. In primary care settings where on-going relationships, continuity and trust are important – the ideal option (often not possible) is an in-house trained interpreter. The complexity of interpreted consultations needs to be appreciated in making good judgements when choosing the best option to optimise communication and in assessing when there may be a place for family interpreting. This paper examines the elements of making such a judgement.
Additional keywords: care of limited English proficiency patients, communication barriers, interpreter services, translating.
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