Executive summary

Effective communication between health practitioners and their clients is fundamental to ensure the safety and quality of health care. For the thousands of Victorians with low English proficiency, effective communication in a health setting cannot be achieved without an appropriately skilled interpreter. Yet evidence shows that there are many occasions when credentialled interpreters are not engaged even though they should be, creating risks for both clients and health practitioners.

Communication in health care settings allows the health practitioner to accurately understand the client’s health concerns and symptoms. It enables the client to be able to provide informed consent, understand diagnoses, receive information and understand risks associated with medication or treatment. Compliance with follow-up care also requires effective communication, as does the client’s ability to advise the practitioner of any adverse effects or other concerns regarding treatment.

Around 4 per cent of Victorians speak English ‘not well’ or ‘not at all’. For these members of the community, effective communication in a health setting cannot be achieved without an interpreter who has the necessary range of skills to undertake the task competently and ethically.

Professional interpreting has been a key discipline in the health sector in Victoria for over 30 years. However evidence shows that the engagement of credentialled interpreters is still not commensurate with the needs of the community. The issue is of concern nationally. A recent study found that a client with low English proficiency had only a one in one hundred chance of having a professional interpreter engaged when required in a primary care setting in Australia.

Shortfalls in the provision of interpreting services constitute a major barrier to addressing inequalities in health care.

This study examined a range of evidence about the barriers to - and facilitators of - the engagement of interpreters, as experienced by the health sector and its practitioners. Based on the evidence examined, recommendations are made in relation to:

• Strengthening legislation, organisational and professional guidelines and standards
• Closing gaps in Commonwealth funding for interpreters
• Ensuring Victorian Government funding for interpreters for state administered and funded health services is commensurate with need
• Adjusting the national funding formula for hospitals to provide weighting for the engagement of interpreters when patients have low English proficiency
• Encouraging health services and tertiary institutions to routinely provide training on working with interpreters in professional development and professional practice education
• Promoting organisational development to ensure policy and practices are in place for effective engagement of credentialled interpreters to meet a variety of demands across language groups
• Developing initiatives to ensure the supply of interpreters in new-arrival languages and the capacity of the National Accreditation Authority for Translators and Interpreters (NAATI) to test in these languages.

The evidence also indicates that there is an insufficient supply of credentialled interpreters who have skills in working in complex health environments. There is a compelling case for a broad national workforce and industry review.