This post is part one of two. The first part will explain generally what a profession is and make distinctions between what some may consider a profession and what is truly a profession. The second post will consider the current comments of government surrounding the MoJ and other contracts to further highlight the fallacy behind outsourcing for those that should be considered professionals and the risks the government are incurring with this strategy.
The term profession is often bandied about. Anyone can call themselves a professional: marketeers, IT personnel, plumbers.
Let’s be clear. There is something beyond these albeit worthy roles. This is about a professional. One who has a Code of Ethics or Professional Conduct, a CRB check, has a high level of training, alongside specialised knowledge and skills, belongs to an organised regulator and has responsibility to a community and is concerned with its welfare above all else.
Teachers will tell you the supply teacher is all but gone in the UK. Rather than employ a qualified teacher to plug any gaps in timetables it is the new employee at the front of the class: one who is on a Registered Teacher Programme (RTP), who is not as yet qualified to teach. Or worse, sometimes it is the Teaching Assistant who is left holding the fort.
Psychologists will tell you that work previously done by highly qualified and trained Psychologists is now being done by those trained in IAPT: Improving Access to Psychological Therapies. You now need to pass a one year course to deliver CBT.
Nurses will tell you a lot of their work is now done by Health Care Assistants.
There are many similarities between the above three professions and interpreting, whether spoken or for sign language. You should be bound by a Code of Ethics or Professional Conduct, have an enhanced CRB check, professional insurance, be accessing supervision and be registered with the appropriate professional body in order to work. In fact all the criteria mentioned at the start of this article.
What is different with interpreting and what Sign Language interpreters have been discussing for a long time is the lack of legal protection. Were interpreters to be legally protected, it would be illegal to work as an interpreter unless you were a registered professional in the same way you can not legally work as a doctor if you are struck off the medical register held by the GMC.
Why? This goes back to the list of what it is to be a professional and the responsibility we have to the community we serve. Over the last 25-30 years we have witnessed and heard terrible stories of what happens when you do not have a registered interpreter. We have fought as a profession to raise and safeguard those standards and to continue to develop the profession.
We have heard about the level 2 ‘signer’ work in a court room (the equivalent of conversational French). We have heard about the police tape that got pulled apart by the defence team due to the sub-standard interpreting causing the eventual collapse of a case. We know the all too familiar stories of mishaps, misdiagnoses, even deaths. We all know the students who leave schools and colleges without qualifications because they didn’t understand the ‘communicator’. These aren’t the stories of yesteryear, the bad old days before we had a register and better qualifications, though both of those points are moot. These are fast becoming today’s stories.
You would not allow a Health Care Assistant to draw blood or dispense medication. You would not allow an IAPT practitioner to diagnose someone with schizophrenia. You would not allow a Teaching Assistant to deliver A Level Physics or PSHE. This creates rather than mitigates risk. Risks to standards, to service delivery, to people.
When you allow an untrained, unregistered interpreter to work in a hospital, a courtroom or a police station you play with risk, you create risk. And nobody present can monitor that.
It is why we have Codes of Ethics for professionals. Interpreters, in the same way as other professions, cannot always be monitored. They are responsible for monitoring their own actions and behaviours, to be responsible for themselves and those they serve. Codes of Ethics were borne out of the Hippocratic Oath, the fundamental principle of which is do no harm.
Employ someone who is not a professional, you no longer have those safeguards. No matter what monitoring has been added to the contract the commissioner is not omnipresent. Even if they were they would not be qualified in assessing whether that person was competent and had successfully completed their duties. Does the commissioner, judge, solicitor, doctor, nurse have access to the languages the ‘interpreter’ purports to know? Is someone unregistered really someone you can trust?
The only safeguard is simply to use a professional, one who is appropriately trained and registered. In the UK, where a framework agreement exists for interpreting that safeguard has been all but removed.
statutory
There are 4 posts tagged statutory (this is page 2 of 2).
Interpreter Cost Cutting: A False Economy
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.