26 May 2021

The Interpreter Project

An interdisciplinary project regarding the consequences of the law introducing user fees for interpreter services in the Danish health care system.

Inequality in health is a major theme in Danish health policy and in research at the Department of Public Health. The law from 2018 introduced user fees for interpreter services in the health care system for patients who have stayed in Denmark for more than three years, and this law may lead to greater inequality regarding access to the health care system. This is the focus of a collaboration, “The Interpreter Project”, between the Center for General Practice, the Research Center for Migration, Ethnicity and Health (MESU) at the Department of Public Health and the Department of Nordic Studies and Linguistics (NorS). We are examining the consequences of the law for immigrant patients, for doctors and for the communication in the health care system.

The project has until now shown that the use of professional interpreters has decreased significantly after the introduction of the law. Thus, many immigrant patients refuse to use an interpreter when in contact with the health services, or refrain from seeking help due to their financial situation. The doctors are required to assess whether interpreter service free of charge is necessary for the treatment of all their patients who have stayed in Denmark for more than three years. These basic conditions can put the doctor in both a legally and ethical dilemma. In addition to the quantitative analyzes regarding the extent of the use of interpreter services, our project focuses on the understanding between the general practitioner and the patient in the consultation room when no professional interpreter is present. Further, we focus on hospital doctors and general practitioners’ experiences and perspectives in the wake of the required payment for interpreter services. We likewise investigate the experience of contact and communication during consultations without an interpreter present. This, with a focus on the patients’ experience of being able to formulate their problems, the doctors' experience of the opportunities to practice professional and the ethical and legally dilemmas that occurs as a consequence of language barriers. In the project, we use data from national registers, interviews with doctors and patients and video recordings of consultations in general practice. The video recordings are analyzed using linguistic methods.

The interpreter project represents a fruitful interdisciplinary collaboration across both faculties and two departments at the Department of Public Health. The project uses various theories and methods in order to document the consequences of a controversial health policy initiative. The results can shed light on whether there is greater inequality for particularly vulnerable groups in the population and thus create a better basis for health policy decisions in relation to the interpreter services in the health care system.

The research group includes the following from the Center for General Practice: two experts in psychology of language, postdoc Johanna Lindell who is also affiliated with NorS and research assistant Cæcilie Hansen; professor Susanne Reventlow, associate professor emerita Annette Davidsen who works with qualitative phenomenological methods and associate professor Melissa C Lutterodt, who has several years of clinical experience with foreign language speaking patients in general practice. MESU is represented by research assistant Camilla Michaëlis, professor Marie Nørredam and professor emeritus Allan Krasnik, who all have significant national and international experience with research concerning immigrant health and health service research in general. From NorS we have associate professor Christina Fogtmann with special expertise in psychology of language and communicative comprehension processes.

The results of the project will along the way, be conveyed in scientific papers and as comments and analyzes in relevant professional and daily newspapers, etc. Furthermore, we expect later to organize an open joint seminar concerning the consequences of the interpreter service fare. Additionally we expect to do a short summary report to distribute to health policy and integration policy spokesperson as well as relevant organizations, etc.

The project is funded by, Doctor Sofus Carl Emil Friis and his wife Olga Doris Friis 'Scholarship, General Practitioners' Education and Development Fund and the Research Unit for General Practice.

By Allan Krasnik and Melissa C Lutterodt