Language barriers present a major obstacle to minority ethnic communities accessing primary healthcare. Whereas it is recognised that interpreting services are generally inadequate and inappropriate reliance is placed on family members to interpret, little is known about how nurses working in primary care utilise interpreters to overcome language barriers. The present paper reports on a study examining the utilisation of interpreting services by a range of primary care nurses from the perspectives of the nurses, interpreters and minority ethnic communities. Focus groups were undertaken with five separate groups of district nurses, health visitors, practice nurses, community midwives and specialist nurses, three groups of interpreters from different interpreting services, and five groups of participants from the main community languages in the locality where the study was undertaken (i.e. Arabic, Bengali, Cantonese, Somali and Urdu). Focus group discussions were tape-recorded and subsequently transcribed. Data analysis drew upon the principles of 'framework' analysis. The use of interpreters by primary care nurses varied considerably. Nurses who had received training in using interpreters and who had most control over the timing of patient visits were more likely to use interpreting services. Inadequate training of both nurses and interpreters adversely affected the quality of interaction where interpreters were used. Primary care nurses acted as gatekeepers to interpreting services. Whereas interpreting services were generally perceived to be inadequate, many nurses were accepting of the status quo and prepared to rely on family members to interpret rather than champion the need to improve services.

This article examines the social exclusion experienced by Chinese people in Britain. It challenges the view that the problem is caused by the cultural characteristics of the Chinese community. It shows that the main cause lies in their way of seeking social integration through market participation. The necessity for many Chinese families to secure their market position not only keeps them at a distance from mainstream society but also from their own ethnic community. While they are not outsiders in either of these groups, they only have one foot in each of them.

Two analytical tasks have been conducted in this article. The first is to construct a defamilisation typology that covers eighteen OECD members and four tiger economies (namely Hong Kong, Taiwan, South Korea and Singapore). The second is to demonstrate this typology's contribution to the debate on the existence of two essential preconditions for the development of an all-encompassing East Asian welfare regime: (1) the existence of significant differences in the welfare systems between the East Asian countries and the non-East Asian OECD countries; and (2) the existence of significant similarities in the welfare systems of the East Asian countries.

for Hospices and Specialist Palliative Care Services, 1995. tion, our analysis has indicated that professional-2. National Council for Hospices and Specialist Palliative patient communication with Chinese patients Care Services. Wider Horizons. London: National Council d for Hospices and Specialist Palliative Care Services. 2001. needs to take account of differing understan ings 3. Department of Health. Reducing Health Inequalities: an and values placed on individual autonomy versus action report. Our Healthier Nation. London: HMSO. 1999. collective family decision making.

Since Esping-Andersen classified the 18 Organization for Economic Co-operation and Development (OECD) countries into the "three worlds of welfare capitalism" in 1990, the comparative studies of welfare have been dominated by the responses to this study. This paper focuses on two of these responses. The first response is concerned with the gender insensitivity of Esping-Andersen's way of categorizing the welfare regimes. The second response is concerned with the issue that the East Asian countries are under-represented in the 18 OECD countries. To make contributions to these responses, two analytical tasks are conducted. First, we build new defamilisation typologies covering both East Asian countries and OECD countries. Second, we demonstrate that the evidence generated from the typologies suggest that some of the indispensable conditions for the development of a Confucian welfare regime do not exist.