Suspended Gauteng Health head of department Dr Barney Selebano claims that the pressure to move patients to NGOs came from former Gauteng Health MEC Qedani Mahlangu. After protracted efforts to avoid testifying, including a High Court appeal, which was dismissed with costs, Selebano was warned by the chair, former Deputy Chief Justice Dikgang Moseneke, that his submission would be arduous and highly debated.
According to an IoL report, this was during his first appearance before the Life Esidimeni alternative dispute resolution.
The report said he had tried to avoid appearing before the hearing by challenging a subpoena ordering him to do so. This was scuppered when the Johannesburg High Court dismissed with costs his urgent application to set aside the subpoena. Acting Judge Daniel Berger had ruled that Selebano had failed to establish a basis on which the subpoena can be challenged. He then applied for leave to appeal, but this too was denied with costs by Berger.
The report says appearing before arbitration chair, retired deputy chief justice Dikgang Moseneke, Selebano testified that he first became aware of issues with the project around July/August 2016. “There were reports coming from the media and the Democratic Alliance (DA). That’s when I knew there were problems.
“I got to know that patients who had been moved from Esidimeni had demised.
Selebano then revealed that he got in touch with the Health Minister Dr Aaron Motsoaledi, who called for immediate intervention to prevent further deaths.
There was then a scramble to move patients from the NGOs, with Selebano adding that he personally shut down the NGOs where patients died. These included Precious Angels, Siyabadinga, Siyabathanda and Bakang among others.
The matter continues.
Selebano is a key figure in the Esidimeni project in which 1,700 mentally ill people were transferred to ill-equipped NGOs after Gauteng Health terminated its contract with the Esidimeni group. At least 143 of these patients died.
Eyewitness News reports that Selebano’s lawyer attempted to have him only apologise to families gathered for the deaths of their loved ones. Senior counsel Owen Cook told Moseneke that his client has already told the Health Ombudsman that he takes accountability for his part in the tragic project. “I do not see that my client can be of any assistance to this dispute resolution process.” But Moseneke told Cook that Selebano would be protected if anything unfair is put to him during cross-examination.
State lawyer Tebogo Hutamo then told the hearing that Selebano will not be treated differently to any other witness who has appeared before him. “He can’t be treated any different from all other witnesses.”
Selebano kicked off his submission, which Moseneke warned would be arduous and highly “debated”, by answering questions on the grounds for issuing a 29 September, 2015, “letter of notice of cancellation of contract between department and Life Esidimeni”. Selebano told the evidence leader “the notice was issued on the advice of managers from finance, mental health and legal” after he was “told to sign”.
The Citizen reports that this response elicited robust cross-examination from both the evidence leader and Mosekene, as they both pressed Selebano on how he dispensed his duties as the head of department. He attributed everything to the public service bureaucratic system, which he said kept him from intervening even in cases where there was prima facie evidence that patients transferred to illegal NGOs were facing hardships.
“There was fiscal pressure, the contract has been there for a long time, and there was a certain amount (paid), and it was felt that it was high. It was one of the contracts where it was discussed to find the same way of getting the same value at a lower cost. It is known that the department of health has pressures because demand of inward migration … under pressure to provide services,” Selebano told the hearings.
He vehemently denied as unreasonable the expectation that he should have been on top of the project once the decision to distribute the patients to different NGOs around the province was taken.
The report said reassuring Moseneke that he was not “obfuscating” his failure to give direct answers, Selebano said: “At a granular level, the HOD will not know. The mental health directorate said this is how we are going to move patients.”
He conceded that despite agreeing with this recommendation after receiving a presentation from Dr Makgabo Manamela and her team of deputy directors and assistant directors, he left it to the “workforce” to implement. When asked why he didn’t intervene much earlier to prevent the death of the patients, he mentioned being “careful not to jump my colleagues and speak to deputy directors and assistant directors”.
The report says he stressed several times that his red line in the department was only to Dr Lebethe, who is the deputy director-general in charge of clinical services. He said it was Lebethe’s responsibility to then convey his concerns to Dr Phila Mazamisa, a chief director whose directorate oversaw Manamela’s work.
He said when he received the call from Motsoaledi, 36 people had already died: “It was emergency, and I told them we are running. The MEC called a meeting where the whole matter was discussed. Personally, I was no longer interested in meetings. I wanted to save as much as possible.”
Selebano also told Moseneke he did not seek political permission from his immediately supervisor, Mahlangu, as this was a purely administrative matter that had received an in-principle greenlight at prior meetings. He said if he had tried receiving a go-ahead from his political principal, that would have delayed the decision to cancel the contract unnecessarily.
Moseneke told Selebano that he and the families were hoping to get answers as to what had really happened, reports The Times. “We still hope somebody senior will come and tell us what happened. It is a very important part of healing‚ Dr Selebano. Sometimes we know out of hindsight‚ sometimes‚ we know out of inferences. You are a very vital part of this. You are the man who signed off on the plan.”
Selebano was asked more than ten times by Moseneke why he moved patients out of NGOs. He would only say that it was because he had been instructed to. He initially would not speak on the poor conditions at NGOs‚ despite repeated questioning on this.
Moseneke asked: “What was the bad situation that required patients to be moved?”
Selebano said: “The bad situation was what minister said. We are in a situation that have people demised.”
The report says after three hours on the stand and endless questions‚ he finally admitted NGOs were “not fit for purpose”.