Establishing the infrastructure needed to take proper full-time care of mentally ill patients is an expensive exercise, and should never have been regarded as an area where costs could be cut.
These were the thoughts of Professor Malegapuru Makgoba on day two of the Life Esidimeni Arbitration hearings in Parktown, Johannesburg. The process is aimed at gaining closure for the families of 118 mentally ill patients who died after being transferred from Life Esidimeni facilities to irregularly licensed NGO’s established to care for them in a cost-cutting exercise.
Makgoba is the Health Ombudsman who headed the inquiry into the transfer of over 1 700 patients from private healthcare facilities into the care of cheaper NGO’s, many of which were established purely to take care of the patients at a lower cost to the Department of Health.
As the state’s first witness he told the alternative dispute resolution headed by former Deputy Chief Justice Dikgang Moseneke that during his inquiry he found that the national ministry was out of the ‘loop’ with the decision by the former Gauteng Health MEC Qedani Mahlangu to move mentally ill patients from Life Esidimeni (LE) to NGOs.
“I’ve searched through literature from around the world because the whole thing about institutionalisation is invoked, and I could only find two countries where this was attempted. In all of them, they took a different route from the one taken here in South Africa. At the end of the day, I can only say this. It is more expensive.”
Makgoba told the hearing that the ‘big migration’ of mentally ill patients transferred to the newly established NGOs took place mostly in Tshwane between May and June 2016.
His inquiry had found that most of the NGOs were not fit for purpose and not ready to accept the patients placed in their care. Almost all them had been illegally granted a one-year operating license by the Director of Mental Health, Makgabo Manamela, who has been suspended.
“None of the NGOs met the criteria to be granted licenses as NGOs that should care for mentally ill patients,” said Makgoba.
On the first day of the hearing families of those who died in the tragedy heard how cutting costs had been the main reason why government had terminated its contract with Life Esidimeni.
The department had been paying Life Esidimeni R320 per person per day, while the NGOs were paid only R112 per person per day.
Makgoba’s report titled “No Guns 94+ Silent Deaths And Still Counting,” said the NGOs were unable to cater for the special needs of the patients and were not adequately prepared for the task.
“The lady in charge of Anchor said she had to look for money. She never disclosed her donors, but said she was so cash-strapped she had to look for funds because she had these patients under her care.”
Anchor is one of the NGOs that Makgoba had recommended be closed down because the highest number of deaths had happened there.
Makgoba said when he began his inquiry in October 2016 he has was given a list of 27 NGOs by former MEC Mahlangu and only discovered during his investigations that 30 NGOs had been involved.
Mahlangu, who a resigned the night before the report was released, is not of the list of the state witnesses called to testify before the arbitration. Other witnesses expected to be called are Minister of Health, Aaron Motsoaledi, current Gauteng Health MEC, Gwen Ramokgopa and Gauteng Premier David Makhura.