Breaking down language barriers

The movement of human populations over vast distances in the search for a better or safer life is not new,1 but the 20th century has been distinguished by migration on a unprecedented scale: 90 million people may now live outside their country of birth, over 13 million of them refugees.2 Their countless individual journeys have transformed the demographic characteristics of large Western cities, which are now home to many different minority ethnic communities. The NHS was established before the period of greatest immigration into the United Kingdom, and doctors could once have expected to share the same culture and language as their patients. This expectation has changed— minority ethnic groups comprise 6% of the UK population3—but it is far from clear that the NHS as a whole has changed rapidly enough, especially in the inner cities, to meet the challenge posed by patients whose …