NHS: Access to Services (Hansard, 8 February 1999)

§ Lord Hunt of Kings Heath
Yes, my Lords. The Department of Health's strategy is to ensure that all groups have effective and equitable access to services by implementing the NHS. Modern and Dependable White Paper. This includes training staff on cultural issues; providing interpreter, advocacy and translation services; and providing information on the NHS and health issues in different languages.

§ Lord Clement-Jones
My Lords, I thank the noble Lord for that positive reply. Perhaps I may ask him in 5 particular whether the Department of Health is considering the provision of qualified interpreters such as are being introduced into the criminal justice system.

§ Lord Hunt of Kings Heath
My Lords, the current policy is to delegate that decision down to individual trusts. In the past few years we have seen trusts employ many more interpreters and link workers. That has proved to be very successful. However, we are looking at a recent report published by the King's Fund on link workers in primary care. We will be exploring with the King's Fund and others ways in which to take forward this issue. We will look at the national system as regards criminal justice to see whether any lessons can be learnt.

§ Lord Ahmed
My Lords, can my noble friend inform the House whether Her Majesty's Government are satisfied with the health of ethnic minority communities?

§ Lord Hunt of Kings Heath
My Lords, there is an issue concerning the varying inequalities in health among all groups. agree with my noble friend that inequalities in health among ethnic minority groups is a particularly serious problem. It is one of the reasons we invited Sir Donald Acheson to produce a report on tackling health inequalities. In his conclusion he recommended that the needs of minority ethnic groups should be specifically considered in terms of the allocation of resources to the NHS and specific programmes. We are considering our response to that report at the moment.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that there is a very great volunteer element in interpreting? Is he further aware that, as a dentist, I regularly had people come to my surgery with a friend or relative? Would it not be better to encourage that volunteer element rather than to involve ourselves in the vast expense arising from the court system, which I recall as a magistrate?

§ Lord Hunt of Kings Heath
My Lords, I am glad to pay tribute to the work of volunteers in helping the NHS in this area. We rely on volunteers and members of families to help people who use the NHS by interpreting for them. However, there are circumstances where it is not appropriate—perhaps in the case of a child or someone who does not speak English as a first language—for a volunteer to be present at a consultation. It is essential that we have the back-up of a professional service as well.

§ Baroness Ludford
My Lords, given the Minister's earlier reply, with which I agree, will he confirm that extra funding will be made available for those health authorities that need to employ professional translators; for instance in inner London, where patients may speak any of some 60 languages? Given that the funding of services for ethnic minorities is under pressure in the education sector through local government grants, will the Minister assure the House that that element of health funding will not be under pressure?

§ Lord Hunt of Kings Heath
My Lords, as I have said, in considering the outcome of the Acheson Report we 6 shall examine its recommendations in relation to funding. We already include in the capitation formula for allocation to health authorities an allowance for what is termed the English language difficulties adjustment. well understand the pressures on many inner-city health authorities. It is worth pointing out that, for instance, the East London City Health Authority budgeted in 1996–97 for nearly £3 million to be spent on interpreting services.

§ Baroness David
My Lords, I appreciate what the Minister said about national health trusts, but will he tell the House what information is now available to them as regards the needs of language and the cultural backgrounds of the people in their area so that the trusts can provide a baseline from which to plan appropriate services?

§ Lord Hunt of Kings Heath
My Lords, the most comprehensive set of data on local areas is provided by the 1991 National Census. However, that records only ethnic group and country of birth, not language or religion. Therefore, information at local level is more likely to be the product of local initiatives on the part of health authorities or local authorities in commissioning surveys.
The development of the new NHS proposals, particularly given the intention to develop health improvement programmes in consultation with local authorities and taking in primary care groups and NHS trusts, will provide the motivation to ensure that the information we have is as accurate as possible. That will then help us to plan the kind of services that we require.

§ Lord Astor of Hever
My Lords, is the Minister aware that there is no legal requirement for GPs to be able to speak English, and that that can in certain circumstances be dangerous for the care of patients? Will the Minister undertake to look into the matter?

§ Lord Hunt of Kings Heath
My Lords, I shall respond to the noble Lord on that issue. In relation to the training of doctors in this country, we have made it clear to the medical schools that we wish them to ensure that all medical students well understand the needs of a multi-cultural society.