Arbitration process for families of deceased Life Esidimeni patients: Week 1
By: Lindi Sirame
On 30 June 2015, a mass distribution of mentally ill patients took place. More than 500 psychiatric patients were transported in buses and others restrained and placed at the back of bakkies without canopies. They were headed to NGO’s sourced by the Gauteng health
department, without their medical history or identity documents as part of plans by the department to cut costs by moving them out of a private hospital. Families were not notified of these plans and were left searching for their loved ones some of whom had already died by the time they were located.
Despite Life Esidimeni being a private hospital, psychiatric patients who were accommodated here were not paying for care as they were beneficiaries of the South Africa Social Security Agency – SASSA. The health department’s decision to move the patients from the Private hospital to NGO’s would see them saving R200 per patient as the NGO’s would charge them a little over R100 per patient. The department of health had been dealing with a financial crisis for the last five years and was under strain because of urbanization.
The Health Ombudsman released a report in February 2016 detailing the shocking treatment that the psychiatric patients were subjected to.
The report found that:
1. All 27 NGO’s to which patients were transferred were operating without licenses.
2. 16 out of 27 NGO’s reported that psychiatric patients from Life Esidimeni died in their care.
3. The number of patients who died at these NGO’s was ten times higher than at public hospitals, leading authorities to believe that the deaths were caused as a result of conditions at NGO’s.
4. The decision to move the patients was flawed with inadequate planning and a ‘chaotic’ and ‘rushed’ implementation process.
5. The project has brought pain and anguish to many families and has brought national and international disrepute and embarrassment to South Africa’s health system.
6. The department continued with the transfer of patients despite advice by experts as well as concerns by civil society organisations.
7. Patients were transferred to far away places from their homes without the knowledge of the families.
The reason for the deaths varied but the Health Ombudsman report found that some patients died because they were moved while they were sick. Some had signs of respiratory conditions like breathing abnormally, chronic conditions such as TB, Hypertension and jaundice. Others died from dehydration and hunger.
Releasing the report, Health Ombudsman Malegapuru Makgoba gave provisional numbers of the patients who died.
Health Ombudsman releases Life Esidemeni report
COURTESY OF ENCA
Two years later the Health Ombudsman Malegapuru Makgoba’s prediction that the death rate may increase was confirmed. Testifying at the Arbitration Hearings, HOD Dr Ernest Kenoshi said 141 patients have died since February this year.
The Gauteng Health department now has to answer for the deaths of the psychiatric patients.The three week long process to bring closure to the relatives of the deceased began on October 9 2017, it was led by retired Judge Dikgang Moseneke. As proceedings got underway the families of the deceased received news from the Health Department’s lawyer that their calls for former health MEC Qedani Mahlangu to testify and account for her role had fallen on deaf ears. Mahlangu was not on the states list of witnesses’s however, lobby group Section 27’s promised that they would seek legal avenues to ensure that she testifies. Mahlangu resigned shortly after the Health Ombudsman released the report.
In the first week of the arbitration hearings, these five state witnesses testified:
Health Ombudsman Professor Malegapuru Makgoba
* Former Gauteng Health MEC Qedani Mahlangu forced to move mentally ill patients to NGO’s knowing the risk involved.
* Some NGO’s had to raise money themselves to take care of the patients they received from the Gauteng health department.
* Some families did not know where their relatives were moved to and had to search for them for weeks.
* Families should have been treated with utmost respect by the Gauteng health department, they were not.
Chief director of policy and planning at the Gauteng department Levy Mosenogi
* No disciplinary or criminal proceedings have been taken against anyone who was directly responsible for the transfers.
* There was no written plan to move hundreds of mentally ill patients.
* As project manager, he was not aware that some patients were moved in the back of bakkies without medical history.
* Apologized to the family members for the loss of life and appealed to colleagues and ANC government not to repeat the mistake.
The National Director General of the department of health Precious Matsoso
* Matsoso only found out that mentally ill patients were moved from Life Esidimeni to NGO’s through a television interview that former Health MEC had on eNCA.
* Never received a project plan on the process of ending the departments contract with Life Esidimeni and relocation of patients.
* Communication from lobby group Section 27 was the first written notification she received regarding the deaths.
* Some of the deceased were being kept at funeral parlor’s which do not comply with regulations, including a former butchery.
* Some patients were accommodated at an NGO where bedrooms were in a horse stable.
Acting HOD of the Department of Health Dr Ernest Kenoshi
* There are 35 case dockets opened in relation to 118 deaths.
* We know where 111 are buried, 7 others remain unclaimed in mortuaries.
* Some NGO’s would bury the mentally ill patients without notifying relatives.
* 23 more people have died since Ombudsman released report in February 2016, bringing the death rate to 141.
* 820 mentally ill patients were moved from NGO’s in 3 months.
* 31 patients from Life Esidimeni are still at NGO’s with their family’s consent.
* 5184 patients are at NGO’s in Gauteng and government is ensuring their safety.
Director General in the office of the Premier Phindile Baleni
* Testified that the Premier’s office was not aware that the Gauteng Health Department had terminated the contract with Life Esidimeni. She says in its February 2016 report to the Premier’s office, the Health Department omitted any reference on the process of moving patients from Life Esidimeni. Baleni says the department only reported that their entire year plan was on track.
* Three Officials and an NGO have filed appeals against the Ombudsman’s report.
* Officials from the Gauteng Premier’s office are working with police to investigate the deaths, those found responsible will be charged.