Addressing patients' linguistic unease: a comparative evaluation of the design of healthcare language policies in South Tyrol and Northern Ireland

Abstract

This thesis presents an evaluation of the design of public policies that address communication difficulties faced by patients who speak a language other than the local majority language when seeking healthcare assistance. This includes both members of autochthonous minoritised groups (respectively German and Irish speakers) and migrant speakers of allochthonous languages. The considered case studies are South Tyrol (Italy) and Northern Ireland (United Kingdom).

The central concept in this work is that of patients’ communicative and/or symbolic “linguistic unease”, the reduction of which is conceptualised as the ideal final goal of healthcare language policies.

Within the epistemological framework of a public policy approach to language policy, the concept of linguistic unease was hence operationalised into a series of dimensions amenable to systematic evaluation. These were developed based on medical, sociolinguistic and language rights literature, as well as being enriched through the findings from qualitative interviews carried out with patients, healthcare professionals and interpreters/mediators in the case-study regions. The dimensions were translated into a detailed list of recommended policy outcomes, constituting an original diagnostic tool to assess the relevance and quality of healthcare language policies.

This tool was then applied to the case study regions. The design of healthcare language policies in these contexts was analysed, and comparatively evaluated, based on the criteria of relevance, comprehensiveness, plausibility, testability and feasibility.

Brief summary of findings
In South Tyrol, the provision of language-concordant healthcare for autochthonous German speakers seems mostly well-designed, but would benefit from a focus on staff’s sociolinguistic awareness and more competitive salaries. For speakers of allochtonous languages, there is a design for adequate provision for interpreting, but single measures are disconnected and, in some cases, discontinued, incomplete, or awaiting implementation at the time of writing.

In Northern Ireland, there is no plan for the provision of language-concordant care for Irish speakers at the time of writing; main points to target at this stage include the valorisitation of already available linguistic resources within the workforce and the introduction of signage in Irish. For speakers of allochtonous languages, provision of interpreting services is mostly well designed, but selection and training processes of prospective interpreters, as well as their working conditions, must be improved; more monitoring of the quality of the telephone interpreting service is also necessary.

Thesis is embargoed until 31st May 2028

Date of Award	May 2026
Original language	English
Supervisor	Michele Gazzola (Supervisor), Philip McDermott (Supervisor) & Sabrina Bunyan (Supervisor)