Disabled people and those with mental health problems are being
left in pain and distress following medical assessments to
determine their right to claim disability benefits.
Examples of disabled people having limbs manipulated or being
requested to perform tasks which are painful are outlined in a
Commons social security committee report.
The report examines the medical service since it was contracted
to Sema Group, a private contractor, in September 1998,
concentrating mainly on assessments for incapacity benefit,
disability living allowance and attendance allowance claims.
Other incidents reveal doctors as brusque and intimidating, with
claimants experiencing discomfort and embarrassment during
It also reports insufficient time being spent with claimants;
inaccurate recording of information; claimants kept waiting for
unacceptably long periods; and examinations cancelled at short
The committee backed Mind's recommendation for better training
on mental health issues for all examining doctors.
It says that a review of medical services' treatment of
claimants with mental health problems is needed, covering time
spent with claimants; doctors' expertise; the ability of the system
to assess accurately the nature of mental health problems; and what
scope there is for reducing distress to claimants.
"Our inquiry has led us to conclude that, so far, the primary
focus of Sema has been on operational efficiency to achieve value
for money, rather than the delivery of a quality service from the
point of view of the individual examinee," says the committee.
"It would be naive to blame Sema for trying to make a profit -
that is its business. The onus must be on the Benefits Agency and
the department to monitor medical services. If necessary it will
have to renegotiate the contract to ensure that financial pressures
do not lead to a lower quality service."
Medical services and the Benefits Agency must take urgent steps
to achieve better treatment of claimants as present performance is
not acceptable, it says.
Doctors were also laying themselves open to charges of
institutional racism by failing to adequately train in cultural
awareness and failing to make claimants whose first language is not
English aware that they can request an interpreter.
Doctors who are insensitive to people from ethnic minorities
should receive immediate remedial training and be monitored. The
Commission for Racial Equality should be called in to review the
work of medical services, it recommends.
The goal of contracting the service to improve service to the
public has not been achieved, it concludes.
A Department of Social Security spokesperson said clinical
audits of medical services work as part of the Sema contract had
Sema Group, which prior to the contract had no experience of
running a medical operation, declined to comment.