I can't see what the alternative is, Brian. If people turn up ill at A+E in the UK, and the hospital is duty bound to treat them in any case, then it is not in the hospitals best interests to turn them away or not make every attempt to understand what the matter is. You can't not treat people because you don't understand whats wrong nor can a hospital demand payment in advance for translation services assuming they can pay, if there may be life threatening consequences in any delay. I speak good French and a little Spanish, but I wouldn't want to have to rely on my ability to do so if I am taken ill or been in an accident and in pain, as I probably wouldn't remember the words under complete stress. Everything would probably come out in my own language.

You mention Somali and Albania, which are likely to be immigrant/refugee groups, but what if the injured are Japanese/French/German tourists? Surely in your analysis the same issues would apply?