The power of words

05 June 2018
  • Claire Flood-Page tells us more about our Speak My Language report. We look at the consequences of not making services accessible to all.

    In a recent court case, an NHS Trust in England will have to pay millions of pounds in compensation [opens in a new window] after a baby was left severely brain-damaged[1].

    The High Court ruled that Barking, Havering and Redbridge University Health NHS Trust was liable for Nilujan Rajatheepan’s injuries because midwives failed to explain how to feed him properly in a way she could understand.

    Nilujan’s parents were Tamil refugees from Sri Lanka. His 21-year-old mother arrived in the UK in 2008 and spoke only a few words of English. He was born on 16 July 2009 and discharged two days later. When she left the hospital at 10pm with her husband and a friend who spoke better English, the baby was crying constantly. When they sought help, midwives told them that newborn babies cry a lot. His mother gave evidence that she tried to raise her concerns but could not do so because of her lack of English. When the community midwife arrived the next day, the baby was pale, drowsy and had reportedly had seizures. He was hypoglycaemic and suffered catastrophic brain damage. Experts agreed that this was because of poor feeding.

    The Judge said no one explained to Nilujan’s mother, the importance of feeding or what to do if he wouldn’t feed. The midwives believed they had overcome the language barrier through gestures and signs. But the Judge said the midwife should not have conducted the formal discharge interview without, at least Nilujan’s father present (who could have interpreted for his wife). Better still an interpreter or the hospital’s language line. If language barriers had been overcome, the judge concluded that mother and baby would have been kept in hospital overnight. Nilujan would have avoided injury. In April 2018, the Trust apologised to the family and said it had improved since 2009.

    This case highlights the tragic results that can happen because of language barriers. It also reinforces the health bodies’ duties all patients despite their language barriers.

    How can public bodies avoid this?

    We can all agree, situations like this shouldn't happen.

    Our report Speak my language: Overcoming language and communication barriers in public services [opens in a new window] looks at how public bodies are supporting people to access services if they cannot speak English or Welsh. This group includes deaf people who use sign language. We looked in particular at interpretation and translation services.

    The report makes some recommendations to improve services. We created a checklist that public bodies can use [opens in new window] to help. The more public bodies  do to understand and respond to the language needs of their communities, the less likely a situation like Nilujan's will happen again.


    About the author

    Claire Flood-Page is a performance auditor. She leant about language barriers first-hand when she lived at a hospital in rural KwaZulu-Natal in South Africa in the 1990s. She often struggled to communicate because of her limited command of the Zulu language.

    [1] Rajatheepan v Barking, Havering And Redbridge NHS Foundation Trust, Court of Appeal - Queen's Bench Division, April 13, 2018, [2018] EWHC 716 (QB)