The HSE's new intercultural health strategy will recommend the establishment of a national interpretation service to improve services provided to immigrants across the State.
The strategy, which is due to be launched in the new year, will suggest that current fragmented services are causing distress to non-English speakers and health workers and that there is pressing need for a standardised system, The Irish Times understands.
Arrangements currently vary from one hospital or GP's clinic to another, with rural areas in particular having difficulties in finding reliable and timely services. It is common for immigrants with poor English to use family members - including children - or friends when they visit a hospital or GP, increasing the risk of misdiagnosis and raising serious issues about patient privacy.
In a survey carried out by the Irish College of General Practitioners (ICGP) in 2003, GPs identified a lack of interpreters in the health system as the single biggest barrier to offering high-quality medical care to asylum seekers and refugees.
It is understood the strategy, while pointing to steady progress in training healthcare staff in the use of interpreters, will argue that the proposed national service using trained, accredited interpreters should be accompanied by further staff training.
The intercultural health strategy, which has been in preparation since May 2006, will make broad recommendations across a range of areas to improve the health system's capacity to handle the shifting needs of a multicultural population.
To address the paucity of information on the situation of minority ethnic communities, the document will recommend the implementation of an ethnic identifier similar to the question in last year's census. Information on ethnicity would be collected at the first point of contact with the health system and would be available alongside data on religion and country of birth.
On women's health, the strategy will point to the need for greater awareness of the specific problems faced by women migrants, from trauma experienced by asylum seekers to a fear among others of contact with official services.
With the low uptake of antenatal and postnatal care programmes, and the challenge of expectant mothers presenting to maternity hospitals in advanced stages of pregnancy, the strategy will suggest more effective ways of reaching out to minority ethnic women.
It will also propose that health personnel be trained in dealing with conditions that certain minority groups may be predisposed to and are not familiar within the Irish health landscape, such as sickle cell anaemia and other haematological conditions.
The document is also likely to explore how the HSE should handle cases where individuals express certain cultural or religious beliefs or practices, such as the circumcision of infant boys, that make specific demands of the health service. Accommodating other cultural and religious needs - relating to personal hygiene, facilities for worship and dietary needs, for example - will also be considered.
As some people from minority ethnic backgrounds may not be functionally literate even within their own languages, the authors will advise greater emphasis on visual and spoken messages. They will also stress more frequent translation of documents and the use of simplified English.
The intercultural strategy is based on wide-ranging consultation with staff and service users since May 2006 and draws on issues raised through roadshows, focus groups and surveys, as well as written submissions from interested groups.
