Advocating for inclusivity in Dutch healthcare

In a recent interview with Simone Goosen, a prominent figure in the Dutch healthcare sector, we delved into the changes to language policy in the healthcare sector and the campaign she as been running to promote medical interpreters for all.

Meet the advocate: From epidemiologist to campaigner

Simone Goosen, with a background in epidemiology, spent five years with the World Health Organization in Africa before transitioning to the Dutch public health services. Between 2001 and 2014, she wore dual hats as a researcher and policy advisor, focusing on issues such as patient rights and contraception payments for asylum seekers. In 2015, the advocate's attention shifted to medical interpreters in healthcare, marking the beginning of a compelling journey. Today she works for the Johannes Wier Foundation, a non-governmental organization committed to human rights in Dutch healthcare.

A funding cut and its repercussions

Prior to this, in 2011, there was a significant change in the political landscape in the Netherlands. With a new cabinet in power, budget cuts came into effect, impacting the Ministry of Health's funding for medical interpreters. The previous national telephone service, a lifeline for healthcare professionals seeking interpreters, faced a sudden halt due to the budget cuts. The subsequent fallout from this decision created a critical situation for both healthcare providers and their diverse patient population.

Inability of individuals to solve language problems

Simone Goosen recounted the challenges that ensued as a result of the funding cut. The initial government stance, urging individual patients to solve the translation needs themselves (by learning the language), led to fragmented and inadequate access to interpreters. Most patients didn’t or couldn't solve the issue themselves. This put pressure on healthcare providers who needed interpreters to do a good job.

“The healthcare providers were left to fend for themselves.”

A fragmented access to interpreter services

To solve this, associations of academic hospitals joined forces to find their own solutions for this. So did associations for medical practices. Regions in the larger cities solved the funding by cooperating with healthcare insurance companies. Even as some institutions managed to find solutions, disparities and unequal access to interpreters persisted. And in cases where healthcare professionals had access to interpreters, stories emerged of pressure on them to limit interpreter use.

“I heard a story of a pediatrician, and she worked in regional hospitals as the one to see all the refugee and migrant children. And, of course, she would need the interpreter more often than others. They would really start to put pressure on her to stop using interpreters so much. Even though she technically had access to interpreter services, there would be a lot of pressure to limit the use.”

Dual projects for healthcare equity

Today, Simone works at the Johannes Wier Foundation, a non-governmental organization promoting human rights in Dutch healthcare. They are currently running two large projects.

"This is a child, not an interpreter"

The “Interpreters back in healthcare, please” campaign is working to influence politicians to bring back the national interpreter telephone line, as well as informing healthcare staff of the serious consequences of using children as interpreters.

Together with patient organizations, the foundation is also developing new professional guidelines for dealing with language barriers in health and social care. Essentially, giving healthcare professionals advice on how to handle situations with relatives interpreting. For example, how they can assure themselves that the patient consents to having the relative interpret, and assessing the situation to understand if it is appropriate for the relative to interpret or not.

Setting a precedent for healthcare globally

The experience that the healthcare sector in the Netherlands has undergone after the budget cut for medical interpreters serves as insight into what can happen in Sweden and other countries if the funding for medical interpretation is cut. At the same time, the work that Simone Goosen and the Johannes Wier foundation are doing serves as a beacon for other nations grappling with similar challenges, highlighting the importance of professional guidelines and engagement. As the Netherlands strives to restore a unified system for medical interpreters, we hope that this comprehensive approach will set a precedent for a more inclusive and equitable healthcare landscape globally.