In these times of fiscal belt tightening funds have to be cut. It’s a given. For statutory bodies it must be hard. So where does the funding get cut and how can they save money?
Cut the stationery budget. There will be fewer pens. Don’t provide sandwiches at meetings. Staff and visitors will feed themselves. Take away the water cooler. There’s a tap.
Say you’re a nurse or a doctor within an NHS trust. Or you are staff in a local authority, the police or the courts. How about trying the following options. What would happen if you did?
Don’t provide an interpreter:
We know the US has a more litigious culture. Here’s what happened there:
Failure to use an interpreter ended in a $71m malpractice lawsuit in the U.S where a Latino boy was suspected to be a drug user but actually had a brain aneurism. A late diagnosis left him a paraplegic.
£400k was awarded to a Deaf woman who was not afforded an American Sign Language Interpreter and could not understand the side effects of her Lupus medication.
Last year, a Sheriff was sued for keeping a Deaf man in custody for 25 days without an interpreter.
What about here in the UK?
In 2004, Mr Tran Quang Tung died at Dungavel Immigration Removal Centre. He hung himself. There was a continued lack of interpreters used by doctors and other members of staff even though they could have done due to systems that were in place.
In summary, a professional is breaking their own code of conduct if they cannot communicate with their patient or service user. Guesswork does not amount to being able to care, treat or diagnose them. Crossing your fingers will not work either. Primum non nocere is the benchmark of medical ethics: “First, do no harm”. If you are court staff, justice is unlikely to be achieved. Local authorities, you are not filing your statutory duty.
Use an unqualified or unregistered interpreter:
It is quicker and cheaper to get someone who you think can do the job but is not qualified or registered. Perhaps use someone’s spouse or another member of family?
In 2000, in an A&E department, the wife of a profoundly Deaf man, Sarwat Al-Assaf, was used to interpret questions to her husband such as do you have thoughts of harming your wife or children? Mr Al-Assaf was suffering from severe mental illness. He later went on to kill his wife’s new partner.
Perhaps you get someone who says they have some sign language qualifications or in the case of a spoken language get in, say, the Polish-speaking porter.
One interpreter points out that “The English translation for the word ‘hit’ in Punjabi and Hindi is ‘maar’, but it also means ‘to kill’,” she explains. “So if I’m in court I have to ask the person: are you saying ‘I’m gonna hit you’, or ‘I’m gonna kill you’?” You don’t want to mess around with that distinction, whether it’s in court, for the local authority or a medical appointment.
Every registered interpreter has a tale of how there was an ‘interpreter’ booked but they got called in a week later to sort out the mess, usually to find out that the ‘interpreter’ was someone unregistered who took the payment because they could. It is obvious that in these cases, the service provider has to pay out more. Like getting in a cowboy builder, it ends up costing twice as much to get the mess sorted out afterwards.
It is illegal to employ an unregistered nurse or doctor who will not have to adhere to a Code of Ethics. It is not yet illegal for an unregistered ‘interpreter’ to work as one. Still, it stands to reason that if you use someone who is untrained and unregistered there is no legal recourse when it all backfires as it did in the cases above.
Commission an agency to do it for you:
Perhaps you are an NHS trust, a council or the MoJ and your commissioners are responsible for purchasing interpreting provision. In times of financial austerity, commissioners of services generally tend to care more about costs than quality. In that case, allow them to award an agency a contract or framework agreement with built in standards to ensure quality but ultimately, said agency will not follow them. The agency can not, as it is too costly to get in the appropriate practitioners, i.e. registered interpreters. In order to win the contract, they had to go in too low. The unit costs, if too cheap, can not add up to someone who does the job right and in a professional manner.
So what do you end up with? See the first two options. Rather than not providing the interpreter or getting in someone who is untrained and unregistered, the agency will be doing that instead. You’ll still be paying for it anyway. Freedom of Information requests show agencies are charging the cost of a registered interpreter but not necessarily providing one.
Not much of a cost saving then. Unless the commissioner chose a reputable agency. They normally charge more though so the likelihood is the statutory organisation or commissioner did not make that choice.
The Solution:
Pay for a trained and registered interpreter to:
Avoid – malpractice, misdiagnosis, wasted time, wasted cost orders, being sued and the distress of those to whom you are supposed to be providing a service.
Ensure – you are abiding by the code of ethics of your profession, you are providing the service you are supposed to, you are getting value for money, and you are able to complain or simply to trust that the proper communication is taking place.
How to save money:
Book and pay for a trained and registered interpreter.
How to check if an interpreter, from an agency or one that is booked direct, is registered:
Check the interpreter’s name against the lists held by NRPSI (spoken languages) or NRCPD (sign language). On their arrival ask to see their ID card.
These registers have been in existence for a while for good reason. Avoid the cowboy, avoid the lawsuit, avoid paying out twice.