Empowering minorities. Pathways for basque language integration in a bilingual setting

Abstract

Introduction: The Basque Country is a bilingual setting, where a significant part of the population have Basque as its mother tongue. The Basque NHS, Osakidetza, offers public universal assistance. It adopts an integrated approach through merging hospitals and primary care to achieve better quality of care and efficiency. Communicating in the mother tongue helps patients enjoy equitable and better care. In this context the first clinical pathway in Basque has been recently set up reflecting patient centered care, where fostering Basque is a safety and quality issue. Organization, objectives and result management of the bilingual pathways: Pathways are started from the general practitioners´ (GP) surgeries. Medical consultations, information booklets, test results and informed consents are bilingual. When specialized care is needed, the GP must also point out the patients` language preference by means of an on line request to the specialist. This means that there is a direct clinical pathway available entirely in Basque, from primary to specialized care. This paper offers an evaluation of the bilingual pathway established in 2015 at the urology unit at Debagoiena Integrated Health Organisation (IHO) and paediatric urology at Araba IHO where weekly consultations were provided. During the first year, 987 consultations in Basque were counted in Debagoiena unit, that is, 21.3% of the total. These figures closely reflect the language profile of the local population where, although 60.5% are Basque speakers, only 28.3% use the language on a daily basis. Considering that 25% of the specialists are fluent Basque speakers, only 56% of these patients could be offered the full pathway in Basque. Nevertheless, 100% of them have shown their full commitment to the scheme. The most remarkable results were found amongst the Araba IHO users, in the paediatric urology service. 18.6% of the consultations were in Basque. Considering that just 23% of the population speaks Basque in Araba, this appears to be a high percentage. All those who request provision in Basque can enjoy it, as all the urologist at this unit are bilingual. 100% of the patients assert their satisfaction with the pathway. Although patients were given assitance in Basque, the majority of online notifications between consultants were answered back in Spanish. Conclusions: In line with patient centered care, Basque language pathways have been developed, improving Basque use, patients self-esteem and empowerment. This step forward is specially important in Araba, striving for the positive development of quality care in a bilingual setting. Despite these facts, there is still hard work to be done regarding the normalisation of the Basque language, especially because nowadays Basque is not a common means of comunication between professionals.