Fluency in the consulting room.

T HE analysis of communication is a complex topic that has been the subject of many disciplines, including philosophy , linguistics, and sociology. Within the sociology of health there has been an increase in the number of studies on the role of communication within the consultation process. 1 Two papers in this issue belong to this genre of research — they focus on communication between doctors and patients where the patients are not native speakers, and are a timely reminder of the increasing multicultural and multilingual nature of European societies and the challenge this poses to the provision of public health. Patients who do not have language skills to communicate with their GPs often rely on junior members of their family to act as interpreters. The study looking at bilingual young people's experience of interpreting in primary care by Free et al, shows that when problems arose in the health care encounters they were because of health care professionals' communication skills, the language skills of the young people acting as interpreters , and the nature of the health care problem. 2 Given that it is still uncommon to have regular trained interpreters available in surgeries where there is a large allophone population , the reliance on bilingual youth is inevitable and therefore it is important that healthcare professionals are aware of the special needs of junior family members acting as (untrained) interpreters. The need for greater training in communication skills for healthcare professionals is further endorsed in the study by Bischoff et al, which demonstrates that after healthcare professionals had undertaken special training programmes on how to work with interpreters, non-native speakers' experiences of healthcare encounters improved as a result. 3 Both of these papers recognise the importance of good communication for positive healthcare outcome and endorse what is now increasingly considered to be good practice in health care; i.e., the provision of inter-pretive and translation services. In addition, both studies point out that the effective use of an interpreter requires appropriate training for healthcare professionals, so that they know how to use interpreters. Thus, the use of interpreters is not something that is supplemental to healthcare provision but points to fundamental questions in the way in which healthcare professionals communicate with their patients. The problems of fluency in a language may be easy to detect when dealing with allophone patients. However, the problem of fluency cannot simply be reduced …