SA Health Minister Aaron Motsoaledi is satisfied with the progress made in the relocation of former Esidimeni mentally ill patients to suitable facilities, but, according to a Sunday Tribune report, he says more work still lies ahead before the scandal can be to put to rest. By Thursday of last week, only two patients remained stuck in non-governmental organisations (NGOS) that they were relocated to from Life Esidimeni, according to the minister. He said this was because the patients were refusing to be moved as they got “agitated” each time an ambulance arrived to fetch them.
Motsoaledi said this was substantial progress, given that 23 patients still needed to be moved by 16 May when he presented his budget vote in Parliament. At the time he said 391 patients had been moved to hospitals, 398 moved back to Life Esidimeni, while 461 patients were moved to Weskoppies, Sterkfontein and other facilities. Nine had gone to general hospitals, while 23 had not been relocated – 19 because their families refused to move them, and four because they refused to get into ambulances.
“I’m pleased because almost everybody has been taken to safe facilities, where these disasters won’t happen. But… we still have to hold inquests to determine the cause of the deaths,” he said.
The report says more than 100 mentally ill patients in Gauteng died after they were moved from Life Esidimeni to NGOS. The NGOS were found to have been neither ready nor equipped to take care of patients with chronic psychiatric illnesses, according to a report by the health ombudsman, Professor Malegapuru Makgoba. In all, the department had moved about 1,371 patients.
Of the 27 NGOS in which patients died, 14 have been closed, while six remain open because they deal with other business not related to psychiatric patients.
Apart from holding an inquest, Motsoaledi said in the report that there was an issue of compensating the families of the patients who died. He revealed that his department had heeded the ombud’s recommendation to opt for mediation through dispute resolution, headed by a prominent South African instead of an open court. “That process is on. In fact we have already agreed with the families,” he said, adding that the department had already identified a person to lead the mediation process.
Motsoaledi said the fact that some of the patients were agitated whenever they were to be moved was another indication that the relocations from Esidimeni were done without due consideration of the patients’ specific needs. Put bluntly, he said, the relocations were reckless. “You need experts, you can’t just move psychiatric patients (haphazardly). You need psychiatrists, you need psychologists, you need social workers. You need occupational therapists, you need environmental care inspectors, you need people who are experts in logistics. That was a team of 60 that I put up, because each one came with necessary skills.
“It’s a mammoth task which was very meticulous, which is what the Gauteng Department of Health should have done in the first place. When they moved them, the reason there were so many deaths was because the NGOS were going there just to collect people, with no experience and no expertise. That was a disaster.”
He said hard lessons had been learnt from the Esidimeni debacle.
“After this, we will regularly be visiting these centres, checking whether they they are licensed and if the quality is good, or if we are going to have another disaster.”
Asked if he was worried that the deaths had happened under his watch as the minister of health, Motsoaledi is quoted in the report as saying: “That one is a judgment I leave in your hands. I have been asked that question before and I said I am not worried.
“I am angry because this shouldn’t have happened. We have a Mental Health Act. We held a mental health summit in 2012 and we even invited the World Health Organisation to come and guide us.
“We called the Health Profession Council and the Nursing Council, the nursing unions and doctors’ unions, the mental health association, psychiatrists, judges, the law reform council and the relevant NGOS,” he said.
“Now, when you check what happened in Gauteng with Life Esidimeni, all of those (rules) were completely thrown out of the window.”
The report says he could not understand how the deaths happened because each province has a Mental Health Review Board (MHRB) to sign before any patient is moved. “Even if the MEC (Qedani Mahlangu) insisted otherwise, that process (MHRB’S decision) must be followed. The board has the last say, but they didn’t do that. That’s why the ombud made one ruling, that the chairperson of the mental health board must be held accountable.”
He supported the ombud’s recommendation that there should be a review of the Mental Health Act, which stipulates that the powers lie with the provinces, the report says.Sunday Tribune report (subscription needed)