A county health watchdog warns that cleaners and catering staff could put patients at risk because of communication barriers, writes Victoria Owen.

Foreign workers at Oxford's John Radcliffe Hospital, for whom English is not their first language, may be unable to read patient notices or understand nurses' instructions, said Oxfordshire Health Council. Many patients are forced to fast before receiving vital treatment, while others are on strict diets. But their health could be in jeopardy if catering workers did not understand nurses' orders or 'nil by mouth' notices.

After a number of visits to the acute care centre, members heard that poor recruitment levels among domestic staff could also cause healthcare problems. And the problem was likely to continue after new hospital buildings were developed at the Headington site. As part of the Private Finance Initiative, a company would own the site and employ the staff.

A report to a recent CHC meeting said: "There was a problem recruiting domestic staff in Oxford at the low rates of pay offered. When the PFI begins, this would include ancillary staff. These difficulties could continue." But trust personnel director Mike Fleming said domestic staff were employed by contractors who were strictly regulated. He added: "The staff work in a healthcare environment where there are certain rules of employment, such as communication skills and confidentiality.

"All have to undergo intensive interviews, where language barriers would be brought to the contractors' attention."