More than £5 million has been spent on translation and interpretation services in Northern Ireland's health service during the last three years, it was revealed.
Spoken and written English is delivered in 36 minority languages, with Polish, Lithuanian and Portuguese among the most common. Significant numbers of migrants from eastern and southern Europe came to Northern Ireland to work in food processing factories or ply trades during the time when the economy was growing.
SDLP MLA John Dallat said the figures were alarming, but a doctor with surgeries in east and north Belfast insisted it was money well spent.
He said: "This represents a mere fraction of the overall health budget. We are dealing with a very vulnerable, unrepresentative, voiceless group of people who've come here as political immigrants looking for political asylum. Many of them have suffered greatly in their own countries - repression, abuse and complicated psychological problems.
"This reflects the humanity in our society and demonstrates a maturity as Northern Ireland moves into a new and inclusive world."
Three hundred and fifty four interpreters work across Northern Ireland, the five health trusts confirmed. Services include face-to-face interpretation, telephone interpretation and written translation of documents.
Mr Dallat said: "These figures are alarming and need urgent reassessment to ensure that the department is getting best value for money.
"While the trusts must ensure people are not disadvantaged due to language difficulties, care should be taken to explore the voluntary and community sector for volunteers who will do this work without charge."
A spokeswoman for Belfast health trust said they were required to ensure equality of access to services and to information for people who are not proficient in English as a first or second language.
Minority ethnic languages are provided on request. Around £5.7 million was spent between April 2009 and January 2012, according to the trust.