There are a lot of people in my area who don't speak English as their first language, actually, there are a lot of people who don't speak English at all.

The reasons why I don't like it when people can't speak English are because it disadvantages them both personally and in society.

Personally I like to be able to talk to the patient themselves, while we often use other members of the family as translators it is a poor substitute for talking to the patient, being able to interpret their tone of voice and body language.

Certain topics can be tricky to deal with via a translator, the recent spate of domestic violence cases I have been going to are much harder to deal with through a translator, I always have the fear that the patient is being misinterpreted either accidentally or on purpose.

Then there are conditions for which some translators are perhaps ill-suited. We often use small children as translators as they often have the best understanding of English. Using a small child to translate for their auntie who is having a miscarriage is always tricky.

A huge part of my job is to reassure people, it's a lot tougher to reassure someone if you can't speak their language.

Then there are the societal problems with people who don't speak English. I go to a lot of places that are quite insular. The people I meet buy all their goods from people who speak the same language as them, their friends all speak the same language and they only watch the television that comes in their language.

This leads to people not becoming a part of English culture. Now, you may call me imperialistic, but I think that English culture is pretty good - we have sex/race/cultural/diasability equality (with varying success), we frown on people beating their children/wives and I'd say that we are fairly open with respect to other people. When people come to live in this country I like to think that they would take on some of these properties, but this is much harder if they don't speak English as it means that they can remain insulated from 'English' culture.

To help with the translating we have 'language line' which is a telephone translation service. It enables us to use our mobile phone as a 'universal translator', which is very cool, but also very expensive. To be honest I'm yet to need to use it - I'm pretty good at understanding people based around body language, the few words of English that they can speak and the waving around of hands.

To be fair, for a lot of people it's not that they can't speak English, but it's more that they are not confident to speak it, I try to encourage them and to provide a space, in the back of my ambulance, where they can try talking English without fear of being ridiculed.

It keeps my working day interesting at least.