A charge for interpreter services in the Danish health service – Doctors' experiences with the scheme

Full and accurate doctor-patient communication is of crucial importance in enabling the doctor to make the correct diagnosis and in ensuring that the patient receives the right treatment. Interpreter services are essential in consultation situations in which a patient and doctor would otherwise not be able to understand each other because of the patient’s poor Danish language skills.

The scheme on an interpreter services charge in section 50 of the Danish Health Act entered into force on 1 July 2018. The scheme applies to everyone who has lived in Denmark for 3 years or more, unless they are covered by a set of specified exemptions.

In this report, the Danish Medical Association and the Danish Institute for Human Rights disclose the results of a survey in which more than 600 doctors account for their experiences with the interpreter services charge and its implications after one year in force.

Before the scheme entered into force, the Danish Medical Association and the Danish Institute for Human Rights, amongst others, warned about its possible negative effect on easy and equal access to health services. Furthermore, it was pointed out that a large share of the patients that the scheme would cover, would be patients that ordinarily are considered socially disadvantaged; i.e. patients for whom easy and equal access to health services is important.

The Danish Medical Association and the Danish Institute for Human Rights also warned that the interpreter services charge would give rise to problems in doctorpatient communication, and that it could influence diagnostics and treatment negatively. It was also suggested that there would be a risk that some patients would choose not to see a doctor at all, even though they needed to. Finally, it was suggested that the scheme would impose yet another administrative burden on a health service already under pressure.

Main conclusions

Sadly, the results of the survey confirm that, to a very large extent, the interpreter services charge is having the expected negative impacts in the Danish health service.

In brief, the report provides documentation that the scheme on an interpreter services charge is having a wide effect on doctors’ work. The scheme makes it more difficult for doctors to perform their work and it restricts the access to health services for the patients covered by the scheme. Thus, the majority of doctors who took part in the survey find that the requirement to pay for interpreter services impairs the quality of the doctor-patient consultation, due to lack of or inadequate interpretation, as patients try to communicate in Danish despite their poor Danish language skills or get help from a relative who is not up for the job.

Recommendation

Based on the results of the survey, the Danish Medical Association and the Danish Institute for Human Rights recommend that the Danish Parliament abolish the scheme on an interpreter services charge.

Please note that this report is only available in Danish but it contains an English summary on page 31.