Low levels of uptake of free interpreters by Australian doctors in private practice: secondary analysis of national data

Abstract

Background: One in thirty-five Australians has poor proficiency in English, and may need language support in health consultations. Australia has the world's most extensive system of fee-free provision of interpreters for doctors, but the degree of uptake relative to need is unknown.

Objective: To assess the current unmet and projected future needs for interpreters in Australia in Medicare-funded medical consultations.

Method: Secondary analysis of Australian Census, Medicare and Translating and Interpreting Service (TIS) datasets. Age-specific rates of non-Indigenous populations who had self-reported poor proficiency in English were applied to age-specific attendances to general practitioners (GPs) and private specialists to estimate the need for language-assisted consultations in 2006-07. The proportion of services where language assistance was used when needed was estimated through aggregate data from the Medicare and TIS datasets.

Results: We estimate that interpreters from the national fee-free service were used for patients with poor proficiency in English is less than 1 in 100 (0.97%) Medicare-funded consultations. The need for interpreters will escalate in future, particularly among those over 85 years.

Discussion: Doctors currently underuse interpreters. Increasing the use of interpreters requires education and incentives, but also sustained investment in systems, infrastructure and interpreters to meet the escalation in demand as the population ages.