The Department of Health says will invest R17bn over the next three years into upgrading public clinics to “workable” levels. Picture: istock
The Department of Health says will invest R17bn over the next three years into upgrading public clinics to “workable” levels. Picture: istock

The Gauteng health department did not have clear and professional criteria to select non-governmental organisations (NGO) to house mentally ill patients, but handed out contracts on the basis of "goodwill", the Health Ombudsman has said.

In his testimony at the Life Esidimeni arbitration tribunal, Prof Malegapuru William Makgoba said there was no rational reason for awarding the contracts for state patients to the unlicensed NGOs. The decision to terminate the contract with long-time private healthcare provider, Life Healthcare, was announced in October 2015.

The department then proceeded to move more than 1‚300 patients from Life Esidimeni psychiatric homes to 27 NGOs, after which 108 died. Another 10 died when they were moved from Cullinan Care and Rehabilitation Centre‚ where they had lived for years‚ and placed with unlicensed NGOs to make space for Life Esidimeni patients. More than 90% of the 118 deaths occurred at just five NGOs.

On Tuesday, the health Ombudsman, who is the first to hold this position in SA, said there were no clear criteria for selecting NGOs. The government awarded the contracts to small and newly established organisations that were often ill-equipped to take professional care of the state patients. "If there were criteria, they were useless criteria because [the NGOs were] not fit for purpose" he said "Licensing is a statutory requirement that was not complied with here."

Makgoba told the tribunal that on inquiring with the former MEC for health and social development, Qedani Mahlangu and her team, about why existing and trusted NGOs were not established, he was told that "they wanted to spread the goodwill of empowerment".

Moreover, the Ombudsman said he found it strange that the mental health review board was far removed from the marathon project. He said the oversight structure failed to provide guidance on the transfer of patients to appropriate facilities.

Six of the NGOs, including Precious Angels and Siyabadinga, have since been shut down.

In a separate process, the Special Investigating Unit (SIU) is probing the procurement of, or contracting by, or on behalf of the department, of services from 28 entities in whose care mental health care users were entrusted and to which payments were made.

The body is also looking into allegations that some NGOs were already licensed and hosting patients, despite not being ready, and others operated without a licence. One NGO was issued a licence prior to its registration as an NGO. Another was never registered as an NGO but, despite this, was licensed. The SIU’s spokesperson Nazreen Pandor said the SIU was hoping to complete the investigation within six months from August.

The arbitration hearings are expected to continue over the next three weeks.

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