‘They said it was not unusual for psychiatric patients to die’

Former Gauteng premier David Makhura told an inquest into the Life Esidimeni tragedy that then MEC of health Qedani Mahlangu said the deaths of 144 mental health patients wasn’t unusual when compared with fatalities in previous years.

The inquest in the Pretoria high court will determine whether anyone can be held criminally liable for the deaths of the patients, who were among 1,500 psychiatric patients transferred from the Life Esidimeni facility to 27 unlicensed NGOs in 2016.

Makhura testified he had called a meeting with Mahlangu after the deaths were announced.

“I was quite livid. We had 36 patients who died in our facilities. How does this happen? How did they die, under what circumstances?”, he said.

“The officials made a presentation. What they basically did was tell me over the past five years how many mental health patients have died. I was shocked that in some years we would have 30 and other years close to 40. They said this is a trend that has been going on for the past few years.

“According to them, the passing of mental health patients in the NGOs was not unusual, it was normal. I issued a statement afterwards. In the statement I dealt with this part of the deaths. I probed them on how they ended up in the NGOs,” Makhura added.

He said one of the explanations that made him doubtful was that the department was implementing the national health policy framework and strategic plan from 2013, which recommended that patients be placed in community facilities and institutions closer to communities.

“I had doubts about their explanation. I had to consult with the national health department. I phoned the minister and we met. The minister said he had appointed an advisory committee and he had instructed the health ombudsman to investigate.

“He made it clear what the department was implementing was not in line with the policy. It requires processes. At that time I was satisfied. From there we worked with the minister,” Makhura said.

In her evidence, Mahlangu said a budget committee led by Makhura made the decision to terminate the department’s contract with Life Esidimeni, the facility where the psychiatric patients had been receiving care. She also implicated former MEC for finance Barbara Creecy.

Makhura said Mahlangu and her team had presented the proposal to terminate the Life Esidimeni contract to the premier’s budget committee and were still going to do some work.

“The PBC didn’t have a problem with what they were proposing ... “[but] the PBC (premier’s budget committee) would be in no position to take a decision on a contract. It’s not something we had authority on. It doesn’t make decisions on contracts or procurement. It would completely be unlawful,” said Makhura.

On Tuesday, Creecy told the inquest the health department was not under any pressure to cut costs when it terminated the contract and instead had been underspending its allocated budget.

“There was no cut in the health budget between the financial years,” she said.

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