Volume 46, Issue 3
  • ISSN 0272-2690
  • E-ISSN: 1569-9889
Buy:$35.00 + Taxes



In a world of increasing globalisation, governments, including Canada, face ongoing challenges in their efforts to integrate immigrant languages and to communicate with their users in public service settings. By exploring the translation policy in health care settings in Ontario, Canada, this research investigates how immigrant language barriers in health care access are addressed there, and probes into ideologies around the issue of immigrant language integration. Ontarian translation policy in health care settings is pragmatic yet cautious and laissez-faire. It indicates inclusiveness to accommodate immigrants; but it also reveals considerable tensions and hesitations. The belief that translation is a necessary measure to secure immigrants’ equal health care rights has been largely overridden at the regional and institutional level in Ontario, hindering further planning and more effective provision. The inadequate value designated to translation in terms of immigrant integration by government authorities, the ambiguous and ambivalent stances of Toronto Central Local Health Integration Network and some hospitals on translation provision against budgetary concern and the expectation for linguistic homogeneity all play roles in determining the flexibility and fluctuation of translation policy in health care settings in Ontario.


Article metrics loading...

Loading full text...

Full text loading...


  1. Bastardas-Boada, A.
    (2013) Language Policy and Planning as an Interdisciplinary Field: Towards a Complexity Approach. Current Issues in Language Planning, 14(3–4), 363–381. 10.1080/14664208.2013.829276
    https://doi.org/10.1080/14664208.2013.829276 [Google Scholar]
  2. BC Provincial Health Services Authority
    BC Provincial Health Services Authority, (n.d.). Spoken Language Interpreting Services. www.phsa.ca/health-professionals/professional-resources/interpreting-services#Access--interpreters
    [Google Scholar]
  3. Birrell, D., & Murie, A.
    (1975) Ideology, Conflict and Social Policy. Journal of Social Policy, 4(3), 243–258. 10.1017/S0047279400004219
    https://doi.org/10.1017/S0047279400004219 [Google Scholar]
  4. Blackledge, A., & Pavlenko, A.
    (2002) Introduction for the special issue Language Ideologies in Multilingual Contexts. (A. Blackledge, & A. Pavlenko, Eds.) Multilingua, 21(2/3), 121–140.
    [Google Scholar]
  5. Blumczynski, P.
    (2016) Translation as an Evaluative Concept. InP. Blumczynski, & J. Gillespie, Translating Values (pp.327–349). London: Palgrave Macmillan UK. 10.1057/978‑1‑137‑54971‑6_16
    https://doi.org/10.1057/978-1-137-54971-6_16 [Google Scholar]
  6. Bowen, S.
    (2001) Language Barriers in Access to Health Care. Ottawa: Health Canada.
    [Google Scholar]
  7. Canada
    Canada (1982) Canadian Charter of Rights and Freedoms. https://laws-lois.justice.gc.ca/eng/Const/page-15.html
    [Google Scholar]
  8. Canada [Google Scholar]
  9. Canada
    Canada (1985b) Canadian Multiculturalism Act. https://laws-lois.justice.gc.ca/eng/acts/c-18.7/FullText.html
    [Google Scholar]
  10. CISOC
    CISOC (2010) Online Training. www.cisoc.net/en/training/online/community
    [Google Scholar]
  11. CISOC
    CISOC (2013, 12). Guide To Working With Interpreters. www.cisoc.net/_files/Guide_to_Working_with_Interpreters.pdf
    [Google Scholar]
  12. CISOC
    CISOC. (n.d.). CILISAT Certified. www.cisoc.net/en/cilisat
    [Google Scholar]
  13. Diaz Fouces, O.
    (2005) Translation Policy for Minority Languages in the European Union: Globalisation and Resistance. InA. Branchadell, & L. M. West (Eds.), Less Translated Languages (pp.95–104). Amsterdam / Philadelphia: John Benjamins Publishing Company. 10.1075/btl.58.09dia
    https://doi.org/10.1075/btl.58.09dia [Google Scholar]
  14. Entzinger, H., & Biezeveld, R.
    (2003) Benchmarking in Immigrant Integration. Rotterdam: Erasmus University Rotterdam.
    [Google Scholar]
  15. Flores, G.
    (2005) The Impact of Medical Interpreter Services on the Quality of Health Care: A Systematic Review. Medical Care Research and Review, 62(3), 255–299. 10.1177/1077558705275416
    https://doi.org/10.1177/1077558705275416 [Google Scholar]
  16. Garrett, P.
    (2009a) Healthcare Interpreter Policy: Policy Determinants and Current Issues in the Australian Context. Translation & Interpreting, 1(2), 44–54.
    [Google Scholar]
  17. (2009b) Is Healthcare Interpreter Policy Left in the Seventies? Does Current Interpreter Policy Match the Stringent Realities of Modern Healthcare?InS. Hale, U. Ozolins, & L. Stern (Eds.), The Critical Link 5: Quality in Interpreting: A Shared Responsibility. Philadelphia: John Benjamins Publishing Company. 10.1075/btl.87.06gar
    https://doi.org/10.1075/btl.87.06gar [Google Scholar]
  18. Gazzola, M.
    (2014) The Evaluation of Language Regime: Theory and application to Multilingual Patent Organisations. Amsterdam/Philadelphia: John Benjamins Publishing Company.
    [Google Scholar]
  19. González Núñez, G.
    (2013) Translating for Linguistic Minorities in Northern Ireland: A Look at Translation Policy in the Judiciary, Healthcare, and Local Government. Current Issues in Language Planning, 13(3–4), 474–489. 10.1080/14664208.2013.827036
    https://doi.org/10.1080/14664208.2013.827036 [Google Scholar]
  20. (2016a) On Translation Policy. Target, 28(1), 87–109. 10.1075/target.28.1.04gon
    https://doi.org/10.1075/target.28.1.04gon [Google Scholar]
  21. (2016b) Translating in Linguistically Diverse Societies: Translation Policy in the United Kingdom. Amsterdam / Philadelphia: John Benjamins Publishing Company. 10.1075/btl.125
    https://doi.org/10.1075/btl.125 [Google Scholar]
  22. (2017) Law and translation at the U.S.–Mexico border: Translation policy in a diglossic setting. InG. González Núñez, & R. Meylaerts (Eds.), Translation and Public Policy: Interdisciplinary Perspectives and Case Studies (pp.152–170). New York/Oxon: Routledge. 10.4324/9781315521770‑8
    https://doi.org/10.4324/9781315521770-8 [Google Scholar]
  23. (2019) The shape of translation policy: A comparison of policy determinants in Bangor and Brownsville. Meta, 64(3), 776–793. 10.7202/1070539ar
    https://doi.org/10.7202/1070539ar [Google Scholar]
  24. Grin, F.
    (2017) Translation and language policy in the dynamics of multilingualism. International Journal of the Sociology of Language 2017(243), 155–181. 10.1515/ijsl‑2016‑0051
    https://doi.org/10.1515/ijsl-2016-0051 [Google Scholar]
  25. (2019) The Role of LPLP in a Changing Landscape. Language Problems and Language Planning, 1–7. 10.1075/lplp.00029.edi
    https://doi.org/10.1075/lplp.00029.edi [Google Scholar]
  26. Gülmüs, Z.
    (2007) Muttersprachliche Ansprache Als Integrationsstrategie. Eine Translatologische Studie Zu Türkischsprachigen Informationsangeboten. Frankfurt am Main: Peter Lang Verlag.
    [Google Scholar]
  27. Health Quality Ontario
    Health Quality Ontario (2015) Quality Matters: Realizing Excellent Care for All. www.hqontario.ca/portals/0/Documents/pr/realizing-excellent-care-for-all-en.pdf
    [Google Scholar]
  28. Healthcare Interpretation Network
    Healthcare Interpretation Network (2007) National Standard Guide for Community Interpreting Services. https://multi-languages.com/wp-content/uploads/2018/06/National-Standard-Guide-for-Community-Interpreting-Services.v2..pdf
    [Google Scholar]
  29. Healthcare Interpretation Network
    Healthcare Interpretation Network (2014) Working with your Professional Interpreter. https://www.occi.ca/occi-publications
    [Google Scholar]
  30. Hlavac, J., Gentile, A., Orlando, M., Zucchi, E., & Pappas, A.
    (2018) Translation as a sub-set of public and social policy and a consequence of multiculturalism: the provision of translation and interpreting services in Australia. International Journal of the Sociology of Language, 55–88. 10.1515/ijsl‑2018‑0004
    https://doi.org/10.1515/ijsl-2018-0004 [Google Scholar]
  31. Isphording, I.
    (2015) What Drives the Language Proficiency of Immigrants?. IZA World of Labor. https://wol.iza.org/articles/what-drives-language-proficiency-of-immigrants/long
    [Google Scholar]
  32. IST [Google Scholar]
  33. Karliner, S. L., Pérez-Stable, J. E. & Gregorich, E. S.
    (2017) Convenient Access to Professional Interpreters in the Hospital Decreases Readmission Rates and Estimated Hospital Expenditures for Patients with Limited English Proficiency. Medical Care, 55(3), 199–206. 10.1097/MLR.0000000000000643
    https://doi.org/10.1097/MLR.0000000000000643 [Google Scholar]
  34. Khandor, E., & Koch, A.
    (2011) The Global City: Newcomer Health in Toronto. Toronto: Toronto Public Health.
    [Google Scholar]
  35. Kumar, N., Laher, N., Sultana, A., & Aery, A.
    (2017) The Right to Language Accessibility in Ontario’s Health Care System. www.wellesleyinstitute.com/health/the-right-to-language-accessibility-in-ontarios-health-care-system/
    [Google Scholar]
  36. Leanza, Y., Boivin, I., & Rosenberg, E.
    (2010) Interruptions and Resistance: A Comparison of Medical Consultations with Family and Trained Interpreters. Social Science and Medicine, 70(12), 1888–1895. 10.1016/j.socscimed.2010.02.036
    https://doi.org/10.1016/j.socscimed.2010.02.036 [Google Scholar]
  37. Li, S., Qian, D., & Meylaerts, R.
    (2017) China’s minority language translation policies (1949–present). Perspectives: Studies in Translation Theory and Practice, 25(4), 540–555. 10.1080/0907676X.2016.1241286
    https://doi.org/10.1080/0907676X.2016.1241286 [Google Scholar]
  38. Marais, K.
    (2015) Translation theory and development studies: A complexity theory approach. New York: Routledge.
    [Google Scholar]
  39. McDermott, P.
    (2011) Migrant Languages in the Public Space: A Case Study from Northern Ireland. Berlin, Münster, Vienna, Zurich and London: Lit Verlag.
    [Google Scholar]
  40. Meylaerts, R.
    (2011a) Translation Justice in a Multilingual World: An Overview of Translational Regimes. Meta, 56(4), 743–757. 10.7202/1011250ar
    https://doi.org/10.7202/1011250ar [Google Scholar]
  41. (2011b) Translation Policy. InY. Gambier, & L. van Doorslaer, Handbook of Translation Studies Vol. 2 (pp.163–168). Amsterdam/Philadelphia: John Benjamins Publishing Company. 10.1075/hts.2.tra10
    https://doi.org/10.1075/hts.2.tra10 [Google Scholar]
  42. (2017) Studying Language and Translation Policies in Belgium: What can We Learn from a Complexity Theory Approach?Parallèles, 29(1), 45–59.
    [Google Scholar]
  43. Meylaerts, R., & González Núñez, G.
    (2018) No Language Policy without Translation Policy: A Comparison of Flanders and Wales. Language Problems and Language Planning, 42(2), 196–219. 10.1075/lplp.00028.mey
    https://doi.org/10.1075/lplp.00028.mey [Google Scholar]
  44. Morcol, G.
    (2010) Issues in Reconceptualizing Public Policy from the Perspective of Complexity Theory. Emergence: Complexity and Organization, 12(1), 52–60.
    [Google Scholar]
  45. O’Rourke, B., & Castillo, P.
    (2009) ‘Top-down’ or ‘Bottom-up’? Language Policies in Public Service Interpreting in the Republic of Ireland, Scotland and Spain. InR. de Pedro Ricoy, I. A. Perez, & C. W. Wilson, Interpreting and Translating in Public Service Settings (pp.33–51). Manchester: St. Jerome Publishing.
    [Google Scholar]
  46. O’Campo, P.
    (2014, 0718). Reducing the Language Accessibility Gap: Language Services Toronto Program Evaluation Report. stmichaelshospitalresearch.ca/wp-content/uploads/2016/12/LST_Program_Evaluation_Report_July31_one-up.pdf
    [Google Scholar]
  47. OCCI
    OCCI. (n.d.). OCCI Categories and Requirements for Accredited Community Interpreters. https://www.occi.ca/occi-accreditation-framework-details
    [Google Scholar]
  48. OCCI
    OCCI (2014) OCCI publications. https://www.occi.ca/occi-publications
    [Google Scholar]
  49. Ontario
    Ontario (1962) The Ontario Human Rights Code. www.ohrc.on.ca/en/ontario-human-rights-code
    [Google Scholar]
  50. Ontario
    Ontario (1996) Health Care Consent Act, 1996, S.O. 1996, c. 2, Sched. A. https://www.ontario.ca/laws/statute/96h02?search=Health+Care+Consent+Act
    [Google Scholar]
  51. Ontario Citizenship and Immigration
    Ontario Citizenship and Immigration (2017) Citizenship and immigration. https://www.ontario.ca/page/citizenship-and-immigration
    [Google Scholar]
  52. Ontario Human Rights Commission
    Ontario Human Rights Commission. (n.d.). Language-related grounds of discrimination: ancestry, ethnic origin, place of origin, race. www.ohrc.on.ca/en/policy-discrimination-and-language/language-related-grounds-discrimination-ancestry-ethnic-origin-place-origin-race
    [Google Scholar]
  53. Patten, A.
    (2001) Political Theory and Language Policy. Political Theory, 29(5), 691–715. 10.1177/0090591701029005005
    https://doi.org/10.1177/0090591701029005005 [Google Scholar]
  54. Phillipson, R.
    (2003) English-only Europe?: Challenging Language Policy. London: Routledge.
    [Google Scholar]
  55. Pickles, E. [Google Scholar]
  56. Pokorn, N. K., & Čibej, J.
    (2018) Interpreting and Linguistic Inclusion – Friends or Foes? Results from a Field Study. Translator, 24(2), 111–127. 10.1080/13556509.2017.1396406
    https://doi.org/10.1080/13556509.2017.1396406 [Google Scholar]
  57. Quan, K.
    (2010) The High Costs of Language Barriers in Medical Malpractice. Berkeley: University of Califonia. https://www.researchgate.net/publication/234143358_The_High_Costs_of_Language_Barriers_in_Medical_Malpractice
    [Google Scholar]
  58. Rillof, P., & Buysse, L.
    (2015) Getting Organized to Beat Babel in Multilingual Service Encounters. Translation and Interpreting, 7(3), 186–197.
    [Google Scholar]
  59. Rosenberg, E., Leanza, Y., & Seller, R.
    (2007) Leanza, Y., & Seller, R., Doctor-patient Communication in Primary Care with an Interpreter: Physician Perceptions of Professional and Family Interpreters. Patient Educational Counseling, 671, 286–292. 10.1016/j.pec.2007.03.011
    https://doi.org/10.1016/j.pec.2007.03.011 [Google Scholar]
  60. Provincial Health Services Authority
    Provincial Health Services Authority. (n.d.) Provincial Language Service. www.phsa.ca/our-services/programs-services/provincial-language-service
    [Google Scholar]
  61. Ruiz, R.
    (1984) Orientations in Language Planning. Bilingual Research Journal: The Journal of the National Association for Bilingual Education, 8(2), 15–34.
    [Google Scholar]
  62. Sarver, J., & Baker, W.
    (2000) Effect of Language Barriers on Follow-up Appointments after an Emergency Department Visit. The Journal of General Intern Med., 151, 256–264. 10.1111/j.1525‑1497.2000.06469.x
    https://doi.org/10.1111/j.1525-1497.2000.06469.x [Google Scholar]
  63. Sasso, A.
    (2000) Interpreter Services in Health Care: A Call for Provincial Standards and Services. Vancouver: Affiliation of Multicultural Services Agencies and Societies of British Columbia.
    [Google Scholar]
  64. Seneca College
    Seneca College. (n.d.). Language Interpreter Training Program. https://www.senecacollege.ca/ce/language/language-careers/language-interpreter.html
    [Google Scholar]
  65. Serrano, M.-S. C., & Diaz Fouces, O.
    (2018) Building a field: translation policies and minority languages. International Journal of The Sociology of Language (251), 1–17. 10.1515/ijsl‑2018‑0001
    https://doi.org/10.1515/ijsl-2018-0001 [Google Scholar]
  66. SickKids
    SickKids (2017) Interpreter Services Policy. Toronto: SickKids.
    [Google Scholar]
  67. SickKids and TC LHIN
    SickKids and TC LHIN (2010) Improving Health Equity Through Language Access: A Model for Integrated Language Services throughout the Toronto Central LHIN. wiki.settlementatwork.org/uploads/lhin_2010_improving_health_equity_Through_Language_Access_Report.PDF
    [Google Scholar]
  68. Silversides, A., & Laupacis, A.
    (2013, April18). Interpretation services in health care. https://healthydebate.ca/2013/04/topic/quality/interpretation-services-in-hospitals/
    [Google Scholar]
  69. Sinai Health System
    Sinai Health System (2017) Measuring Health Equity. Toronto: Sinai Health System.
    [Google Scholar]
  70. Spolsky, B.
    (2004) Language Policy. Cambridge: Cambridge University Press.
    [Google Scholar]
  71. St. Michael’s Hospital
    St. Michael’s Hospital (2004) Interpretation Services Policy. Toronto: Risk Management Department.
    [Google Scholar]
  72. Statistics Canada
    Statistics Canada (2017a, 0831). Census in Brief Linguistic diversity and multilingualism in Canadian homes. https://www12.statcan.gc.ca/census-recensement/2016/as-sa/98-200-x/2016010/98-200-x2016010-eng.cfm
    [Google Scholar]
  73. Statistics Canada [Google Scholar]
  74. Statistics Canada
    Statistics Canada (2017c, 0720). Language Highlight Tables, 2016 Census. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/hlt-fst/lang/Table.cfm?Lang=E&T=11&Geo=00
    [Google Scholar]
  75. Sultana, A.
    (2018) Language Interpretation Services in Health Care Settings in the GTA. Toronto. https://www.wellesleyinstitute.com/wp-content/uploads/2018/04/Language-Interpretation-Services-in-the-GTA.pdf
    [Google Scholar]
  76. Tipton, R.
    (2012) Public Service Interpreting and the Politics of Entitlement for New Entrants to the United Kingdom. Journal of Language and Politics, 11(2), 185–206. 10.1075/jlp.11.2.02tip
    https://doi.org/10.1075/jlp.11.2.02tip [Google Scholar]
  77. van Doorslaer, L., & Loogus, T.
    (2020) The cautiously pragmatic translation policy in Estonia. The International Journal of Translation and Interpreting Research, 12(2), 63–75. 10.12807/ti.11222.2020.a06
    https://doi.org/10.12807/ti.11222.2020.a06 [Google Scholar]
  78. Wang, W.
    (2020, 12). Bringing Public Services to the Public: Interpreting and Translating in Healthcare Settings for Social Cohesion (Doctoral Thesis). Belfast: Queen’s University Belfast.
    [Google Scholar]
  79. Winnipeg Regional Health Authority
    Winnipeg Regional Health Authority. (n.d.). Language Access. www.wrha.mb.ca/professionals/language/index.php
    [Google Scholar]
  80. Youdelman, M.
    (2019) Summary of State Law Requirements: Addressing Language Needs in Health Care. Washington: National Health Law Program.
    [Google Scholar]
  81. Young, J. [Google Scholar]
  82. Zendedel, R., Schouten, B. C., van Weert, J. C., & van den Putte, B.
    (2018) Informal interpreting in general practice: the migrant patient’s voice. Ethnicity & Health, 23(2), 158–173. 10.1080/13557858.2016.1246939
    https://doi.org/10.1080/13557858.2016.1246939 [Google Scholar]
  83. (2016) Informal Interpreting in General Practice: Comparing the Perspectives of General Practitioners. Patient Education and Counseling, 99(6), 981–987. 10.1016/j.pec.2015.12.021
    https://doi.org/10.1016/j.pec.2015.12.021 [Google Scholar]
This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error