A new in-depth study of language barriers in primary medical care has revealed that there are frequent mix-ups in diagnosing immigrants and refugees because they cannot communicate their problems to their doctors.

The research, initiated by Dr Anne MacFarlane, a lecturer at the department of general practice at NUI Galway, was carried out between 2002-2005 and presented to a national healthcare conference in the city this weekend.

"We found that refugees are very concerned about not being able to communicate with the doctors, to the point that many of them don't even bother going and resort to getting medicine from their home country instead, " MacFarlane told the Sunday Tribune.

"Others go to a huge effort to prepare for the doctor, doing their 'homework' with phrasebooks and dictionaries. A lot of the time they have to use hand gestures, and point at objects in the room to try to communicate their problem, and obviously they leave the doctor very concerned that they haven't got their message across."

MacFarlane said this had resulted in cases of misdiagnosis such as that of the couple seeking fertility treatment.

"There was also a case of a little boy with constipation who was given medication for diarrhoea, " she said.

"The message is getting across to an extent, and then the communication just breaks down."

The research found that many immigrants had tried to break down the language barrier by using a friend or family member as an unofficial interpreter. However, the report found that patients "avoided bringing certain health issues up if their children were present as interpreters", while in some cases the 'interpreter' was no more proficient in English than the patient.

"There were also obvious confidentiality issues, " said MacFarlane.

"In one case, a Croatian woman was using an interpreter from Croatia via the telephone, and she recognised his voice and realised she knew him. Then she started worrying that he had recognised her too.

Even when patients use friends or family, they have to sacrifice confidentiality."

MacFarlane said that, while some GPs use the current commercial interpreting services, they found them time-consuming and difficult to access.

"There is a need for a statutory interpreting service funded by the HSE, and GPs should be aware of the service and use it, " she said.

"That has to be done, and it should be done soon."