The Gauteng health department is hoping to avoid legal battles with families of the almost 1 400 mental health patients removed from state care and placed into the hands of community-based organisations unable to care for them. The revelation comes as families continue to claim bodies from state mortuaries up to seven months after their loved ones died.
Recently appointed Gauteng health MEC Gwen Ramokgopa admits that the department is still trying to ascertain whether all patients removed from state-funded care at private Life Esidimeni health facilities have been accounted for.
“The public is upset that they have been receiving many numbers [regarding patient deaths]. Where we stand, I don’t know. We are still doing a tally and I am not sure even whether we are double counting some patients. I want to be very frank,” said Ramokgopa at a media briefing on Wednesday.
She explained that Life Esidimeni management had provided the department with a database of patients who were removed from its premises.
The province was continuing to work with the South African Police Service and the home affairs department to ensure all patients were traced, she said.
A total of 789 mental health patients remain in the care of 22 nongovernmental organisations and will begin being relocated to established private and public facilities next week, according to Ernest Kenoshi, acting head of the provincial health department.
‘Families voiced their concerns but their voices were muffled’
In October 2015, former health MEC Qedani Mahlangu announced that state-subsidised mental health patients would be removed from care at facilities run by the private hospital group Life Healthcare, of which Life Esidimeni is a subsidiary, to save money. Against the wishes of their families — and despite an attempt to secure a court interdict to stop some relocations — patients were moved in 2016.
Months later, Mahlangu publicly admitted that 36 of these patients had died.
A subsequent investigation by the health ombudsman, Malegapuru Makgoba, uncovered that, at least 94 former Life Esidimeni patients had died — a number that continues to grow as more bodies are traced.
Makgoba added that at the time Mahlangu announced the initial death toll, the number was already more than twice that. He has accused her and others of acting with gross negligence.
“I still do not fully comprehend how it was possible that the Constitution of our land … as well as a plethora of policies and interventions … all failed the most vulnerable amongst us. This is despite the voices and protests by [patients’] families over a protracted period of time,” said Ramokgopa, a former deputy health minister who has now replaced Mahlangu.
Mahlangu resigned the night before Makgoba’s report was released. The document outlined 24 recommendations, six of which were directed at the Gauteng health department. The province, as well as the national department of health and others, now have 23 days within which to report on progress made regarding Makgoba’s requests.
Former head of Gauteng health Barney Selebano and director of mental health services Makgabo Manamela have both been placed on precautionary leave as disciplinary action against them continues.
Despite her resignation, Mahlangu may not be exempt from legal action.
“If there is any law that has been broken, my understanding is that there is recourse through the law,” Ramokgopa said.
She could not confirm whether unlicensed nongovernmental organisations who took patients would face prosecution.
Gauteng looking to fill posts and improve oversight
Ramokgopa said her department was working to fulfil recommendations, including partnering with Statistics South Africa officials to roll out better health information systems, as prescribed by the ombud.
She was also overhauling the province’s mental health review board, which is supposed to act as an oversight body, as well working to ensure doctors were present in all clinics and community health centres.
The province is continuing to trace family members of Life Esidimeni patients.
“There have also been sentiments [expressed], that are very insensitive, that families had ‘dumped’ their loved ones. Many families have been looking for their loved ones. One family on Saturday only informed us then that they didn’t know where their father was,” Ramokgopa said.
“We managed to trace their father and made contact with a mortuary in west Pretoria. The patient had passed away already in August.”
Family members are being urged to contact the department on several phone numbers operating seven days a week, including 011 564 2235 and 011 564 2215.
In October, Mahlangu alleged that public interest law centre Section27, which represents many Life Esidimeni families, was planning to sue the department for its conduct. In late January, Section27 told Bhekisisa it was still determining whether legal action was necessary.
Ramokgopa said she was unaware of any families pursuing legal action against the department, adding that she hoped the department and the families of patients could avoid the courts by following the ombud’s recommendation that an alternative mediation process be used.
She said: “We would not want the families to spend huge amounts of money with a legal process, [but] they need to feel free and as far as the alternative dispute mediation process [goes], they will need to consent to the mediators.”