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 examinations.

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 notice.

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 been improved.

Sema Group, which prior to the contract had no experience of running a medical operation, declined to comment.