I have a feeling this review will strike some debate...

But I will continue.

I'm choosing an element of the NHS service to review - that's off the interpreting service that is given FREE OF CHARGE to all patients who do not have English as a first language or to those that are hard of hearing or deaf (using sign language)

Now, when I talk about this to people I meet and they ask me about my job (I translate freelance for the NHS), the first shouts I usually get are "outrageous, why is money being spent on translating for patients. When in Rome, do as the Romans do, or in this case, I think they are referring to language"

There are three sides to this I would like people to consider:

Those that are in the UK, English is ok, enough for them to get work (i.e. bus drivers, majority are not British born citizens) and contribute to the system. If they are working, paying taxes, but have been diagnosed with pneumoconiosis and diffuse infiltrative pulmonary diseases (which I'm sure most of us would have to look up and find out what the really does mean) and want someone to interpret that into their language. I think they are perfectly within their rights. Being ill is scary.

Next, you have those who seek asylum, for reasons of persecution they are here. Now, I don't believe I'm in a position to judge their circumstances and neither does the NHS, if they have been granted asylum, welcomed into the UK, there is a duty of care.

And yes, you have those who do take advantage, but let's face it; they come in all shapes and sizes, including the Brits themselves....

So it's keeping it in context.

But anyway, the service. It is free and I think that for that reason alone, it's brilliant. It caters for the diverse population the UK has, and the service is covered as part of the NHS budget. Professional interpreters are give the patients time, appointment details and wait for them to arrive, usually asking reception to give them a shout when they arrive if you haven't met the client before.

The interpretation takes place with social services, NHS appointments, PCT appointments, Speech and language therapy appointments and event dental appointments.

The role is to interpret for both the doctor and the patient to ensure each is clearly understood and that appropriate treatment is given.

Pros of the service:

- It is free
- Every patient has a right to one - some clinics get funny about booking them (as it comes out of the clinic's budget, and if they refuse, a patient can still call the service direct and get one)
- You translate during appointments, procedures and pretty much anything else; they have that level of support at all times.
- Probably reducing the likelihood of the NHS being sued (i.e. I said the left kidney hurts.... Ooops, we just took out the right one...etc!)
- Doesn't provide restrictions to access, probably means that ailments are treated before they become more severe and called in via an ambulance, so cost effective in that you're not treating something more potentially serious.
- Preventative advice...etc can be translated too - again, prevention better than treatment = cost effective.

Cons

- People are resentful about booking interpreters and therefore some clinics refuse to book it - thus actually causing more problems for doctors and patients alike to be understood
- Some patients, if they don't keep their appointments, don't cancel (same everywhere) but in this case, there is the added cost also that the interpreter doesn't know, so still turns up, still has to be paid.
- Sometimes if the clinic is cancelled or appointments rearranged, the clinic forgets to inform interpreters, excessive cost in paying the interpreter who shows up when the patient isn't there or the clinic has been cancelled...etc - the patient therefore doesn't have an interpreter at the next appointment.
- Doctors can get very stressed and hurry appointments as an interpreting appointment can take longer

The patients have the opportunity to give feedback so if you're not a good interpreter, you're found out. Each interpreter is signed up to the obvious codes of conduct, need to keep everything confidential...etc - also they try and assign the same interpreter to the patients so its not someone fresh who doesn't know the patients history - really helps, especially if you have potentially embarrassing appointments for the client such as the STI clinic.

In short, it is a great service, it has its flaws admittedly but it provides a high level service and assists in all areas of the NHS run more smoothly with the ease of speaking a common language either directly or via an interpreter, to save lives and get people well.