Tuesday, 8 January 2019

To Skype or not to Skype ?


The plans were unveiled in Liverpool yesterday by Theresa May and health chiefs under a ten-year strategy for the NHS, which sets out how a £20billion cash injection will be spent
Fresh from the news Skype has captions we read the UK NHS declaring support for more of it. 

Yes, some GP's have used Skype for the deaf sign user albeit there is some reluctance to agree to it because deaf prefer people-support direct and regional sign variations can cause issues in following. Those who wanted captioning included may get their way but the recent skype declaration it is now available has been panned as unreliable and unable to differentiate accents. 

But certainly, speech to text translation is getting better all the time. I think using a phone is problematic 'though screens are too small to see all the signing properly and doesn't take into account people with sight issues. The nature of deaf support is sympatico with the translator, often people you know personally and adjudge a friend, know you and your issues and your level of comprehension, so remote support is a concern to many deaf as they won't have that vital background. 

Albeit there are concerns this leads to abuse of translator neutrality and the 'creep in' of the translator meaning well, probably cutting down on detail passed on to accommodate nervous deaf, or assumed/known limited comprehension of some deaf people.  A lot of deaf ask the translator to speak for them since social workers abandoned specialised deaf support in the UK.  Of course, this is illegal and against support ruling, they must remain neutral, but we know it is widespread and still going on.  

The reason this is supported by Skype and other remote approaches is that it saves the NHS money. Even a more immediate and available system than the translator ones who may need notice before turning up.  But some deaf feel this can also put them at risk. I know deaf in the USA successfully sued their hospitals for only offering deaf support this way.  3 years ago ATR did a Welsh survey that found 90% of ALL GP's in Wales failed to offer relevant support to these deaf for a basic diagnosis, hospitals were similar. 

Current charity campaigns suggest nothing has changed either.  Cost is the issue, anything from £40 an hour and often a min demand for at least 2 hours was the norm since the NHS has to cover travel costs as well, in London and other areas 3 times that, then you can see that deaf support is cost-prohibitive, you then see the NHS attraction of remote and centralised support via the net funded by yourself or a charity. 

Systems suggest it is an unreliable service too because the Interpreters are free-lance and pick and choose where they turn up or who they will support.  Recent rows over welfare interviews saw many interpreters of BSL refusing to assist the system or there simply being not enough of them to do it.  Terps could pick and choose the most lucrative options.  Of course allocated GP diagnosis time is less than 15 minutes and some deaf need at least twice that amount of a GP's time, a number of deaf needed 40 mins, which can be extended or curtailed via remote support and can break down in confusion, meaning more interviews have to take place.

The amount of concentration required to follow a screen and the GP on your own can mean it fails. Many deaf simply are untrained in using remote support, and age/infirmity/sight issues etc usually means they will do one of two things, not go to the GP at all or, insist on a human translator.   Little wonder they are not getting ailments addressed, or deaf are feeling put up with it and hope it will go away.