Should the NHS curb spending on translation services?

When the BBC reported the high cost of interpreting services, the conservative estimate was £55 million (€82m; $107m).1 My initial response, as a general practitioner using interpreting services every day, was that this seemed a fairly small sum given the scale and diversity of non-English speakers who are entitled to use the NHS and other public services. I was also troubled by the way the subject was reported, with widespread expressions of concern about waste and the secretary of state for communities and local government asking for a review of language services across government. The message to the public was of a government setting out to find ways of reducing spending in this area. As the complex issues of identity and integration have become of central political concern in the United Kingdom, the government's attitude has shifted.

Full citizenship already requires a test of competence in English. Now we are hearing that non-English speakers have a responsibility to learn English in order to contribute to the process of integration and share in British identity and public life and even to hold on to unemployment benefit.2 The darker side of this idea is …