BMJ discusses merits of telephone interpreting

THE BMJ (formerly known as the British Medical Journal), the world's most influential and widely-read medical journal, has triggered a national debate on the merits of telephone interpreting.

In an article entitled Making the best use of health advocates and interpreters (BMJ volume 325, issue 7355), Kate Adams, a GP registrar from Hackney, wrote, "Although they are not ideal, telephone lines provide a valuable service, particularly out of hours when you need fast access."

Dr Adams's article triggered a number of responses, including one from a Glasgow-based GP who wrote, "Telephone interpreting is simply impractical... It interrupts the flow and is not conducive to building up real rapport... [We have] refused any and all involvement with telephone interpreting services."

In response to these comments, the BMJ published an article by Graham Jones, company secretary of communications company EITI, called A patient-focussed approach to interpreting.

"Let's consider Kate Adams's second scenario, where a distressed non-English speaker wishes to terminate her pregnancy," wrote Graham Jones. "In this case, the patient may prefer the GP to use a telephone interpreter, rather than a 'face to face' interpreter or a health advocate.

"Some non-English speakers take great comfort from the anonymity of a telephone interpreter, particularly in small or closely-knit ethnic communities. One of the factors contributing to the patient's distress in this scenario could well be cultural or social pressures from within her own community. If the patient is forced to talk to her GP with another member of her community in the room, even if that person is a professional interpreter, she may feel unable to speak openly and honestly.

"Another key issue to consider is the number of non-English speakers who have health problems but never see a healthcare professional. There are a number of reasons for this, but the biggest single factor is that non-English speakers are unable to access healthcare services by themselves. Either they must rely on friends or family members to help them, or they must simply 'turn up and hope' that a receptionist is able to put them in contact with an interpreter, health advocate or bilingual member of staff.

"At EITI we are talking to a number of primary care trusts and health authorities about a new TalkBack service that allows non-English speakers far greater access to healthcare services. A series of telephone hotlines are set up, each of which corresponds to a particular language. Calls to the hotlines are answered by an interpreter, who speaks the caller's language, and a TalkBack officer, who briefly determines the caller's need. The TalkBack officer then conferences both the caller and the interpreter with an English-speaking member of staff at the caller's local GP surgery or hospital. Information can then be given to the caller over the telephone, or an appointment can be made for a later date."

August 2002