Ethnic health workers in jeopardy

Health minister Baroness Cumberlege walked into an embarrassing funding row yesterday when she visited a pioneering hospital scheme providing counselling and interpretation services for women from ethnic minorities.

Baroness Cumberlege, Parliamentary Under-Secretary of State for Health, met staff and patients at the Multi-ethnic Women's Health Project at the maternity department of Homerton Hospital, Hackney. She praised their work and said it played a vital role.

But as the Baroness toured the hospital, officials from the the City and Hackney Community Health Council announced that the jobs of two of the community workers on the project were at risk.

The project currently employs five full-time and three part-time members of staff, who between them speak five Asian languages, Turkish, Somali, Arabic, Vietnamese and Chinese. The workers, who see more than 300 women every month, are called advocates, rather than interpreters, because their role extends beyond simply translating.

As the VIP guests waited for Lady Cumberlege to join them for lunch, Mrs Janet Richardson, chief officer of the City and Hackney Community Health Council, which manages the project, revealed that she had just received a letter from the personnel department of the City and East London Family and Community Health Services. The letter stated that the contracts of the Chinese and Vietnamese advocates were only to be extended to the end of this month unless proof of further funding could be given.

The advocates are an independent team, and the pounds 100,000-a-year cost of resourcing the project comes from the East London and City of London Health Authority.

Mrs Jackson said: 'I am extremely concerned at this letter. We had been told by officials that funding had been found to cover the cost of all the advocates, who provide a vital service. The team are already overstretched by the pressure of their workload and demand on their time. We need more advocates not less.'

Mrs Jackson informed the Baroness of her concerns for the team. Lady Cumberlege refused to become embroiled in the row. She insisted that funding arrangements were a matter for health authorities.

The advocates act as links between the women and the system, ensuring that the women have access to all the facilities and knowledge of the treatments available to them. They are recruited not for their medical acumen but for their understanding and links with the community.

Lady Cumberlege praised the project: 'Every year thousands of women give birth, but for each one it is a unique experience. For women coming from another country, with little knowledge of our language or culture, or hi-tech medicine, a labour ward can be very frightening.

'I have no doubt that the use of advocates reduces complications in the births and provides the mothers with a happier experience and the baby with a better start to life.'

Since the Hackney project began, others have been set up in the capital and around Britain.

The Baroness, who is responsible for maternity services and health provision for ethnic minorities, said there were health authorities with high ethnic populations which still used children to translate for their parents or relatives.

She said: 'In my visits around units I am very disturbed when I hear of

children having to translate for their mothers. It is unacceptable that a 10-year-old should have to tell a mother that she is going to give birth to a handicapped baby. A child does not have the use of words to convey such a tragedy to a parent, but it still happens.'

She urged health authorities with high ethnic populations and without advocacy schemes to make the service a priority adding: 'Registers of advocates to be called in, or staff on site, can play a role not just in maternity care but at all levels of health care.'

Yesterday Peter Coe, general manager to the health authorities, said a total pounds 1.25m had been spent on advocacy services in the area. 'The health authorities are doing their utmost to develop advocacy services and it feels like the Community Health Council attempted to manipulate the occasion to get extra money.'

He believed that the CHC had known about the funding situation several weeks before the Baroness's visit and insisted he would be investigating the matter further.

The Baroness was invited to visit the project after meeting Hafize Ece, its co-ordinator at the launch of the Commission for Racial Equality's Code of Practice, earlier this year.

Hafize outlined their vital role. She said: 'We are not simply interpreters, we are trained to understand health issues and to give fundamental advice on how women can have access to all the services and facilities to which they are entitled. If you are a woman from an ethnic minority and English is not your first language, imagine how difficult it is to convey your symptoms

and feelings.

'We had a patient who was believed to be suffering from depression. For 10 days the doctors and an advocate worked with the woman.

It emerged that she had a thyroid imbalance.

'The advocates are not doctors, they do not diagnose symptoms, but they can, by aiding communication and understanding, help the medical experts to get the information they need to make the right assessment.'

The Community Health Council claims the pressures and demands on the service have increased precisely because the co-operation between the medical profession and the advocates team has been so successful.

(Photograph omitted)