What can we do to over-come language barriers and reduce the chance of negligent treatment?

You have a pain but you can’t put your finger on where it is exactly. It is in your torso, but you can’t say whether it is your back or chest; whether it is muscular or whether it is internal. What about when it started? It can be hard enough answering these questions with a sound grasp of English, but if English is not your first language, it can prove to be an impossible and frustrating task.

Being a British Asian of Indian origin, this is a dilemma that I am familiar with. Particularly in the case of my grandparents and older relatives, although they have enough understanding of the English language to get by, having a conversation about a pain or a medical problem can prove to be a step too far.

Often, even if their symptoms are understood, they may be dismissed. Multiple attendances can prove fruitless, missing a vital opportunity to investigate further and introduce timely treatment. In the case of my grand-parents, and probably a majority of the older Asian population, even the thought of complaining or questioning the advice would be unthinkable, with an unwavering respect for the medical professionals they have gone to see.

For me, the above situation is very real, having lost my grandmother in devastating circumstances. At the time, I did not really think about the fact that my grandmother was going back and forth to the GP, but still suffering from the same symptoms. I did not ask her why she was not getting better or why she had not been referred to the hospital. I, like my family, accepted the advice of the medical professionals without questioning it.  Sadly, the outcome would not have been different in my situation, but knowledge is power and being aware of the steps that can be taken if you are unhappy with the advice being given may just make all the difference.

Points to consider

Here is list of points to bear in mind:

  1. If you are concerned that a loved one will not be able to describe their symptoms, or explain how they are feeling, sit down and write down their symptoms so that they can take it to the appointment with them. The GP/Consultant will not be able to properly assess and treat the symptoms if they do not know or properly understand what is wrong.
  2. If you are able and they are happy for you to do so, go with them. Discuss the concerns and issues beforehand so that these can be relayed to the GP/Consultant. Particularly in the case of GPs, time is limited so be concise but be sure to explain what is happening.
  3. If you are unhappy with the advice that has been given, tell the GP/Consultant that this is the case and explain why! It may be that they have not understood how significant the symptoms are and how much they are affecting your loved one. You will not be the first person to say you are unhappy, or the last, and they may not realise that is how you feel. Addressing your concerns will hopefully allow the GP/Consultant to take alternative steps to help.
  4. Ask for a second opinion. If you are still unhappy with the treatment your loved one is receiving or the diagnosis, ask to see someone else. For example, if you think it would help to speak to a different GP, just ask at reception when you book the appointment. Similarly, if they have seen a Consultant at a hospital but are really unhappy, ask for a referral to seek a second opinion. Doing so is not a personal insult and a different view may actually result in a different diagnosis that could save their life!

Making a formal complaint

If you and your loved one are still unhappy, and feel you are getting nowhere, don’t give up.

If you are unhappy with the GP, as a first step, speak to the practice manager. All GP surgeries should have a written complaints procedure, and you can find out more about it at reception or on the practice website. If it is a concern about treatment in the hospital, go and speak to the PALS (Patient Advice and Liaison Services).

Although an informal chat about your concerns may be helpful, my advice would be to always put the complaint in writing.  Particularly when raising concerns on behalf of a loved one, this would allow you time to set out the concerns and ensure key information is not missed. If you do make a complaint in writing:

  • Your complaint should be formally acknowledged, and an investigation should be commenced. At the end of the investigation you will receive a formal written response. The investigation should, ideally, be completed within 25 working days of receiving the letter although it is very possible that it will take longer. The hospital Trust/GP surgery are required to confirm when their investigations will be completed and should write to you before the 25 day period is over.
  • Occasionally, as part of the investigation, you may be invited to a meeting to discuss the complaint. If it is for an older relative or loved one who is not able to communicate adequately in English, you should go with them to ensure that their concerns are addressed.
  • Once the hospital Trust or GP surgery consider that the matter has been adequately addressed, then they should send a full written response. This should also tell you what to do next if you are not satisfied with their response.
  • If you are not satisfied with the response, you have the right to request an Independent Review of the complaint.

Of course, sometimes, no matter what actions are taken, the result will sadly be the same. However, as the next generation of migrant parents, it is important that we do everything we can to encourage and assist the older generation not to be afraid to question and, if necessary, complain about the treatment they are receiving.