The low cost of learning English
Many of us in urban areas treat patients recently arrived from abroad, who are neither fluent in English nor literate.
It increases the time required for consultations and leads to numerous misunderstandings.
Illiterate adults get only limited help from the welfare state. If their capacity for employment is limited by illiteracy, they may be offered free or subsidised English classes at a local college.
But these classes are often oversubscribed. I hear reports they are sometimes rowdy and concentration can be difficult. We can, however, make patients aware of alternative ways to learn English. Doing so may improve their prospects for integration and future health.
Computer courses for beginners are available for a little over £20 . Or, if a literate friend or relative is willing to help, there is a structured multi-sensory reading manual for progression to moderate literacy  It also costs around £20. The Livemocha website offers a basic 30-50 hour course free and an interactive course for a year for $150 .
From Dr Alick Munro