Read our thoughts on Dr Samanatha Gan’s report into the cost of NHS translation services, commissioned by 2020health.

Transcription Global has a number of issues with Dr Samantha Gan’s report on the cost of translation services in the NHS, commissioned by 2020health.

The questions Dr Gan tries to answer, as she sets out at the beginning of her report, are ‘how much is translation costing the NHS, and how can we both cut costs and improve service provision’. Unfortunately for Dr Gan, the answer to her latter question is: you can’t.

Valuing translation services

This week we have seen the consequences of cutting funding to vital language services in the public sector, in this case, the decision by the Ministry of Justice (MoJ) to outsource all court interpreting services to one agency at the expense of the interpreting community. With 60% of professional interpreters refusing to work under the new contract, a contract which cut interpreter pay and expenses, the MoJ was forced to all but abandon the contract as interpreting jobs weren’t being filled and important tribunal hearings were being forced to postpone.

Of course, there are certain aspects of translation services in the NHS that need rectifying, as highlighted by Dr Gan’s report. Firstly, the news that 45% of the 247 NHS Trusts surveyed could not break down the cost of written translation is startling and frankly unacceptable, especially in an age when financial transparency and accountability has become paramount. Secondly, it is bizarre that the NHS does not use a central repository of translated information that is available to all NHS Trusts, and this indicates that leadership of the NHS needs to take a more collaborative approach.

We have an issue with Dr Gan’s conclusion that the costs of translation are on the rise, whilst the cost of written translation is decreasing, summarising that it is the cost of interpretation that is on the rise. This statement is contradictory and inadvertently confusing, as translation and interpreting are two very different disciplines which require different levels of linguistic skills, training and aptitude. Translating and interpreting do not simply operate in different mediums, those being the written and the verbal; the skills required in each profession mean that the costs to acquire each service often vary, and assessing their total costs together will provide a disproportionate summary. This is not only inaccurate as the basis for reform but inconsiderate to the professionals who operate within this industry.

Misguided recommendations

The recommendations derived from the conclusions of Dr Gan’s report are mostly counter-productive. We completely agree that budgetary lines should be introduced to allow tracking and transparency of spending, and it is sensible to create a repository of information that has already been translated for use by all NHS sites.

However, translating materials into ‘easy read’ English rather than other languages doesn’t actually require any translation at all, and as far as we are aware, there are no translators available that are trained in translating from English into ‘easy read’ English. The NHS would be better served by training their staff to write these materials in ‘easy read’ English to begin with, which would then make it easier to translate. Translating public health information is not a contributor to the UK’s language barrier, and like the provision of court interpreting services for non-English speakers, these individuals have a right to the free take-up of healthcare information as well as a fair trial.

Finally, the suggestion that NHS trusts should provide more written translations through free web-based translation facilities such as Google Translate is entirely misguided, imprudent and ill-advised. It is well known that Google Translate is not consistent enough for use in a professional environment, let alone the healthcare industry. This is not to suggest that Google Translate doesn’t provide reasonably accurate translations (for community websites or school reports) – it just doesn’t provide reasonably accurate translations all of the time. To suggest that NHS Trusts should use Google Translate is the equivalent of telling the researchers to use Wikipedia or the doctors to use Web MD.

Access to healthcare information

Dr Gan is right to question whether the current spend on translation services in the NHS is justifiable, and the same question should be asked of any institution which uses funding from the public purse. Similarly, we agree that this report does address ‘deeper issues in our society’, such as integration and the meaning of citizenship. But Transcription Global does not agree that the healthcare system used by non-English speaking citizens is the right platform with which to address these issues. More importantly, Transcription Global does not agree to the reforms that this report recommends, and we suggest that the government looks to recover waste spending in other areas of the public sector before it cuts vital language services, services which we believe form part of this report’s definition of ‘good communication’, which is a ‘critical factor in improving patient education and access to services’.

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