Patients left without crucial information as Covid puts pressure on NSW interpreting services

<span>Photograph: Jenny Evans/Getty Images</span>
Photograph: Jenny Evans/Getty Images

Lack of staff and funding can have potentially ‘catastrophic’ outcomes for patients left in the dark without language services, interpreters say


Interpreting services have faced increasing challenges in New South Wales during the Omicron wave, with patients struggling to access the service and long hold times on phone lines increasing the pressure.

Health workers and community advocates have described a system strained by the demands of the pandemic, especially when visitations are limited or restricted, leaving many elderly patients in the dark.

Amy*, an interpreter for NSW Health who asked to remain anonymous, said the system has long been under strain and the pandemic has only exacerbated long-term issues.

“It’s been grossly underfunded,” she said. “There’s just way too much demand for the amount of staff actually employed. Fifteen people are doing the job of 50 people.”

“There’s not enough interpreters hired to fulfil the requirements and demands that come through, not because of a lack of interpreters, but because of budgeting issues.”

Amy said her department worked out of demountables attached to a hospital, with little support or appreciation for their work.

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She said she had had days where she had to attend to 40 phone calls, and the pressure being placed on interpreters was too great.

“The patients actually miss out when you have so many calls to attend to; it’s extremely difficult to get a professional on the line at the moment.”

“They suffer because of this, especially if it’s an emergency and they don’t have access to language support. It can be catastrophic for them.”

Under the current system in NSW, it is the responsibility of healthcare practitioners to book an interpreter for patients, with some local health districts having emergency priority lines.

If healthcare workers cannot get an interpreter in time, circumstances mean they are being forced to move on to meet the demands of the pandemic.

Sarah*, a healthcare worker who also chose to remain anonymous, said interpreting services have “completely broken down” under the strain of demand and absentees.

She said waits of up to an hour on the phone for interpreters were common, disrupting patients and their treatment plans.

“Interpretive services (are) based on its availability, and the way it is resourced at the moment, it is almost built to be fully inaccessible. You need to have stamina and just general patience to be able to sit on hold for extended periods just to get through to your interpreter.

“We’ve had patients walk into operating theatres who don’t understand where they’re going and why. And no one can speak to them, they just suddenly find themselves being moved.

“Sometimes we’d have family members interpreting from the car over the phone, having to deliver news through tears to their parents,” she said.

But a NSW Health spokesperson said the Western Sydney local health district, which covers some of the most linguistically diverse areas in NSW, was not under strain at all.

“WSLHD Health Care Interpreter Services provide free access to nearly 350 professional interpreters 24 hours a day, seven days a week in over 120 languages including Auslan.”

A spokesperson for the Department of Home Affairs, which runs the national translating and interpreting service, said there had been “unprecedented” demand for the service.

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“The Covid pandemic has increased the number of people accessing interpreter services. Unmet demand across languages is constantly monitored, with new interpreter appointments made to the panel to ensure supply.”

But Dr Archana Voola, policy officer at Western Sydney Migrant Resource Centre, said there was some confusion surrounding the service. Voola said families were unsure how and when to access interpreters.

“There is confusion around who should be requesting the interpreting/translation service – the doctor or the patient? There is [also] lack of clarity on who should pay for this service once it is employed.”

An ongoing issue was the time it took to access interpretive services, affecting diagnosis and instructions.

“There might not be Swahili or Farsi interpreters on call to attend to immediate needs. One thing we have seen over time in the Australian health care services is the lack of/limited usage of the available translation services.

“The consequences of the lack of access could be misdiagnosis, possibly infecting family members and others within their orbit.”

NSW Health said they had also upgraded the system in 2020 and had moved to improve telehealth access, with most interpreter sessions now occurring over the phone or via video conference.

But Costa Vasili, chief executive at Ethnolink, a translation company, said research has shown that a majority of people in healthcare settings preferred face-to-face interpreting.

“The absence of visual cues limits the interpreters’ understanding of the emotional content. There can be technical issues and limits of bandwidth in certain hospitals and clinics. Staff are not appropriately trained to deal with technical issues that can arise.”

Vasili said the service had been “underappreciated” by many, and long-term underfunding had led many interpreters leaving the industry.

“Interpreting services are underappreciated by many Australians and are chronically underfunded, leading to systemic issues in the interpreting sector such as low pay and poor working conditions.

“This leads to professional interpreters leaving the sector to seek out alternative careers that are less stressful and that offer better remuneration and conditions.

“Fair and equitable access to health services in a patient’s preferred language is essential in a multicultural country such as Australia.”

*Names have been changed.