‘Access to work’ is making it impossible for a Norfolk man to do his job

It is good to see a public case study of the effects of AtW cuts on Deaf people and their jobs. There is an article on the DPAC website – Government initiative ‘Access to work’ is making it impossible for a Norfolk man to do his job. Read the article on the DPAC site.

DPAC – 73 Disabled People Die Each Week due to Welfare Cuts

DPAC LogoThe lack of access afforded to Deaf people is shocking. We know that it has got worse since 2009 since outsourcing started in the north west and spread across the UK.

Since the Tories came to power in 2010 (sorry, the Coalition)… welfare cuts have been wide sweeping and have affected the most vulnerable: the bedroom tax, changes to delivery of benefits including PIP, cuts of 50% to local government funding leaving social services crippled, a cash-starved NHS and sanctions which force disabled people (who should not be working) into working for corporate companies whilst on benefits.

What is the actual effect of these changes? 73 disabled people die per week. 73.

All whilst the Tories gave the richest 1% in the country an effective pay rise by slashing the top rate of tax from 50% to 45%.

What is the spin we see in the media? Disabled people are scroungers, tax cuts bring billions into the country. We rarely hear about any of the 73 who die due to these changes. Why aren’t they reported?

And where are Deaf people in all this? They are just the next small group to be targeted by government. A group whose voice is less likely to be heard amongst all the rhetoric. There’s a general election coming whilst people are dying or feeding themselves with visits to a food bank. This does not mean that Deaf people and interpreters should count themselves lucky. It means that we should fight for our jobs, fight for Deaf people to get equal levels of access and we should join in with campaigns. It’s time to start shouting louder and make our voices heard.

Follow Disabled People Against the Cuts (DPAC) for updates on the effects of the cuts and their campaigns against the changes.

Voluntarily Giving Away Work

There is a worrying trend at the moment where voluntary interpreting seems to be used to fill the gap that statutory services and their contractors can not, or rather will not, fill.

The requests for voluntary interpreters as seen on e-groups, lists of jobs within the Deaf community and by text or email are most definitely on the rise. And these are just the ones we can see publicly advertised. They now occassionally include assignments which should be covered by the Equality Act 2010 such as job interviews and training courses. This is not the kind of voluntary interpreting that can be done by trainees to get in some practice.

Many more requests are being sent out by Deaf friends and family desperate to have an interpreter at their health appointments. This by far the worst we have ever seen medical interpreting since we moved away from the so-called helper model of interpreting.

If you want further evidence of a lack of interpreters provided in medical settings just see the increase in blogposts on the subject on Limping Chicken, the surge in activity on Twitter and posts on the new BSL Act campaign’s Facebook page.

Many NHS trusts clearly have little budget for interpreting. What has exacerbated the problem is, of course, outsourcing, especially to spoken language agencies. These agencies, who for many years have ignored standards in spoken language interpreting, are now hellbent on ignoring the standards for sign language interpreting.

A prime example is Pearl Linguistics who are winning numerous contracts on cost. Everything about to be said is fact, well-known in the community and any Deaf person or interpreter unfortunate enough to have had their local NHS trust outsource their interpreting services to Pearl will have started nodding their heads solemnly by now.

Pearl usually have a minimum fee payable to interpreters at £30 per hour for a minimum of £60. No travel expenses are paid. For an interpreter this is only feasible if you can squeeze in several jobs per day with little travel and preferably no extortionate hospital car parking. If you’re also paying back your student loan, additional costs of training and being self-employed the offer looks even more insulting. Oh and that’s without paying national insurance and tax on that sum. Really what’s the point?

Many good Registered Interpreters used to being self-employed are able to get work elsewhere, so they do. What happens then? Pearl say, well we will just use someone learning BSL because to get someone is better than nothing isn’t it? Well, no, absolutely not. These are people’s lives. A wrong diagnosis, the wrong treatment, a fatality are waiting to happen. No wait. They already have, except they are only known about by the few or hushed up, families paid off or wishing to keep their lives kept private.

Rather than reschedule or ensure they fulfil the contract with a suitably registered professional, by setting the fees so low they have an in-built excuse to provide level 2 and 3 BSL learners despite what it says in the contract. We know of some agencies willing to provide someone with level 1 BSL, the equivalent of holiday French.

With the NHS not effectively monitoring contracts and absolving themselves of risk by contracting to a third party what happens? Little or no access for Deaf people and some dangerously risky situations. Pearl are just one of many agencies doing the same thing.

Some personal examples: my elderly Aunt did not get an interpreter at her last hospital appointment. My mother who is diabetic was provided with someone who wanted to be an interpreter and begrudged the cost of the training. I am sure she was quite surprised when told she should get on with it and stop working in hospitals in the meantime. I have got some random texts from people who have found my number on the ASLI directory and asked me to go to a medical appointment with them with the offer of payment from their Access to Work funding. I know of a group of interpreters who working voluntarily supported someone Deaf going through a terminal illness. I see the amount of voluntary requests increasing and for work that previously was paid.

Where does this leave us as a profession? In a sticky predicament and, ethically, between a rock and a hard place. Should you, answers not limited to the following:

A) Interpret voluntarily so that access is given regardless and see a return to the days of the helper?

B) Accept the booking funded by Access to Work and go to a medical appointment thereby being complicit in commiting fraud?

Or C) Refuse someone access no matter what the gravity of their situation and do not allow the NHS or any other statutory service to renege their responsibility?

If we do not want the situation to worsen it has to be the final choice backed up by supporting Deaf people in getting access to their appointments.

Make the phone call voluntarily to PALS. Join and support local and natuonal campaigns run by the Deaf community to campaign for access. Write to your local trust and your MP. Support your local ASLI region and find out what’s going on in your area. Be the bicultural bilingual, ally and supporter. Be a good community interpreter. Just whatever you do, don’t ‘help’.

Interpreter Cost Cutting: A False Economy

In these times of fiscal belt tightening funds have to be cut. It’s a given. For statutory bodies it must be hard. So where does the funding get cut and how can they save money?

Cut the stationery budget. There will be fewer pens. Don’t provide sandwiches at meetings. Staff and visitors will feed themselves. Take away the water cooler. There’s a tap.

Say you’re a nurse or a doctor within an NHS trust. Or you are staff in a local authority, the police or the courts. How about trying the following options. What would happen if you did?

Don’t provide an interpreter:

We know the US has a more litigious culture. Here’s what happened there:

Failure to use an interpreter ended in a $71m malpractice lawsuit in the U.S where a Latino boy was suspected to be a drug user but actually had a brain aneurism. A late diagnosis left him a paraplegic.

£400k was awarded to a Deaf woman who was not afforded an American Sign Language Interpreter and could not understand the side effects of her Lupus medication.

Last year, a Sheriff was sued for keeping a Deaf man in custody for 25 days without an interpreter.

What about here in the UK?

In 2004, Mr Tran Quang Tung died at Dungavel Immigration Removal Centre. He hung himself. There was a continued lack of interpreters used by doctors and other members of staff even though they could have done due to systems that were in place.

In summary, a professional is breaking their own code of conduct if they cannot communicate with their patient or service user. Guesswork does not amount to being able to care, treat or diagnose them. Crossing your fingers will not work either. Primum non nocere is the benchmark of medical ethics: “First, do no harm”. If you are court staff, justice is unlikely to be achieved. Local authorities, you are not filing your statutory duty.

Use an unqualified or unregistered interpreter:

It is quicker and cheaper to get someone who you think can do the job but is not qualified or registered. Perhaps use someone’s spouse or another member of family?

In 2000, in an A&E department, the wife of a profoundly Deaf man, Sarwat Al-Assaf, was used to interpret questions to her husband such as do you have thoughts of harming your wife or children? Mr Al-Assaf was suffering from severe mental illness. He later went on to kill his wife’s new partner.

Perhaps you get someone who says they have some sign language qualifications or in the case of a spoken language get in, say, the Polish-speaking porter.

One interpreter points out that “The English translation for the word ‘hit’ in Punjabi and Hindi is ‘maar’, but it also means ‘to kill’,” she explains. “So if I’m in court I have to ask the person: are you saying ‘I’m gonna hit you’, or ‘I’m gonna kill you’?” You don’t want to mess around with that distinction, whether it’s in court, for the local authority or a medical appointment.

Every registered interpreter has a tale of how there was an ‘interpreter’ booked but they got called in a week later to sort out the mess, usually to find out that the ‘interpreter’ was someone unregistered who took the payment because they could. It is obvious that in these cases, the service provider has to pay out more. Like getting in a cowboy builder, it ends up costing twice as much to get the mess sorted out afterwards.

It is illegal to employ an unregistered nurse or doctor who will not have to adhere to a Code of Ethics. It is not yet illegal for an unregistered ‘interpreter’ to work as one. Still, it stands to reason that if you use someone who is untrained and unregistered there is no legal recourse when it all backfires as it did in the cases above.

Commission an agency to do it for you:

Perhaps you are an NHS trust, a council or the MoJ and your commissioners are responsible for purchasing interpreting provision. In times of financial austerity, commissioners of services generally tend to care more about costs than quality. In that case, allow them to award an agency a contract or framework agreement with built in standards to ensure quality but ultimately, said agency will not follow them. The agency can not, as it is too costly to get in the appropriate practitioners, i.e. registered interpreters. In order to win the contract, they had to go in too low. The unit costs, if too cheap, can not add up to someone who does the job right and in a professional manner.

So what do you end up with? See the first two options. Rather than not providing the interpreter or getting in someone who is untrained and unregistered, the agency will be doing that instead. You’ll still be paying for it anyway. Freedom of Information requests show agencies are charging the cost of a registered interpreter but not necessarily providing one.

Not much of a cost saving then. Unless the commissioner chose a reputable agency. They normally charge more though so the likelihood is the statutory organisation or commissioner did not make that choice.

The Solution:

Pay for a trained and registered interpreter to:

Avoid – malpractice, misdiagnosis, wasted time, wasted cost orders, being sued and the distress of those to whom you are supposed to be providing a service.

Ensure – you are abiding by the code of ethics of your profession, you are providing the service you are supposed to, you are getting value for money, and you are able to complain or simply to trust that the proper communication is taking place.

How to save money:

Book and pay for a trained and registered interpreter.

How to check if an interpreter, from an agency or one that is booked direct, is registered:

Check the interpreter’s name against the lists held by NRPSI (spoken languages) or NRCPD (sign language). On their arrival ask to see their ID card.

These registers have been in existence for a while for good reason. Avoid the cowboy, avoid the lawsuit, avoid paying out twice.

One Stop Shopping

Outsourcing or One Stop Shops. Words that strike fear into the heart of the Sign Language Interpreter. A word that means the work that they previously did direct or though one agency for a council, a hospital or a court now has to go through a larger spoken language agency.

This seems nonsensical to the jobbing interpreter, but ultimately makes sense to the statutory organisation. The logic or process goes like this: we use many interpreters for many different languages. British Sign Language (BSL) is a language. Our staff do not know how to book interpreters so we will employ an organisation who can do this for us. We will save money by employing an agency to cover our interpretation and translation needs (which will include those difficult to source sign language interpreters)…

We will go through a lengthy procurement process where agencies will try to outbid each other to win a contract at a unit price that is ultimately unsustainable. Organisation will expect said agencies to put something in their tender about quality but really it is tokenism for we will only be awarding a contract on the basis of costs. We will award contract to cheapest provider regardless…

Spoken language agency will not understand how to source a BSL interpreter and will sub-contract a specialist agency. They will think they can pay BSL interpreter the same as a spoken language interpreter and when they start the contract will get a big shock. Specialist BSL agency eventually agrees to reduced price sub-contract as all previous work they did is now being outsourced to spoken language agencies who have little understanding of deaf people and BSL interpreters. Specialist BSL agency still wants to survive in market where they get less work. BSL agency asks BSL interpreter to work for less fees. BSL interpreter, if accepting fees, finds they are working for a lot less than before. BSL interpreter is then providing profit for two separate contracts. BSL interpreter considers leaving the profession as they can not survive as an interpreter and must consider another career. Deaf people get less experienced and maybe unregistered interpreters as a result.

Time for a real life example… One of the biggest culprits is Language Empire and Remark Interpreting. Language Empire has a contract to provide interpreting for ATOS. ATOS has the contract for the Government’s Department of Work and Pensions medical assessments. ATOS carry out assessments to decide if the claimant should be allowed incapacity benefit or if they are fit to work. There are problems for disabled people in general with these assessments. MPs themselves have stated the assessments are flawed. The ATOS machine rumbles on… so who do they employ to do the interpreting? Language Empire. An agency who is so ignorant of BSL it calls it British Special Language. The images of hands on its ‘BSL’ page are not of any recognisable signs and they state they have ‘special disability interpreters’. Nobody actually knows what this means. Their webpage has caused BSL interpreters much mirth but complete dismay at their ignorance.

The worst is yet to come. A deaf-led agency has now started to sub-contract for Language Empire. At least the RNID (now Action on Hearing Loss) when sub-contracting for The Big Word stood up for BSL interpreters and helped The Big Word understand the BSL interpreting profession. This organisation has done nothing for interpreters or the deaf community it proposes to serve. They continue to try to source BSL interpreters at greatly reduced cost for what it’s contractors call British Special Language. This particular agency states one of their aims as supporting and enhancing the lives of Deaf, hard of hearing and blind individuals.’ I don’t think so.

Meanwhile we hear of regular reports of yet another council, organisation or government department outsourcing or looking for a ‘one stop shop’. When the agency is not reputable, the cost to the organisation generally remains the same but the quality drops off. With BSL usually representing something around 2% of a contract, the interpreter or deaf person loses out. What used to cost an organisation £100 – £160 per booking average direct, now costs the same or worse (Freedom of Information requests by interpreters show this to be the case due to sub-contracting).

The fact costs have barely been saved is not important. It’s the ramifications to the profession and subsequently deaf people that matters. Spoken language agencies generally do not understand the NRCPD registration system for sign language interpreters. These agencies are more likely to employ someone with level 1 or 2 in sign language (equivalent to a GCSE or A Level in French) thinking this is acceptable. It may be if we were native BSL users but as interpreters, by the nature of the job, we are mostly people that can hear, and we tend to have English as our first language. Therefore, most people with a basic qualification in BSL do not have enough fluency to interpret anything but someone buying a cup of coffee much less a medical appointment. Would you try to interpret consent for an operation to a French man if you had GCSE French?

Every qualified registered interpreter has been to an appointment where the deaf person said but that’s not what the interpreter said last week. Take the case recently of an elderly deaf man who thought he was having a minor operation on his shoulder. The hospital had provided an ‘interpreter’ the week before to sign the consent forms. When the registered interpreter arrived a week later the patient was shocked to discover he would be having a a major operation that day under general anaesthetic. What will it take to stop this… A malpractice lawsuit? A death? Rumour has it that already happened but unless someone actually does anything about it, the government outsourcing machine continues, the big agencies profit and deaf people lose out.