On her second day on the stand at the Life Esidimeni inquest, being heard virtually in the Gauteng High Court (Pretoria) Dr Makgabo Manamela, the former head of mental health at the Gauteng Health Department, detailed how it was not “practical” to move patients to NGOs.
However, she said because of former Gauteng Health MEC Qedani Mahlangu’s “forceful” management style, officials were forced to comply, reports News24.
She said when Mahlangu announced the termination project, there were 1 442 patients at Life Esidimeni hospitals.
The province only had 116 free NGO beds. “We did not have enough NGOs. It was impractical.”
Manamela told the court that she continued with the project because there was a service level agreement (SLA) that indicated patients needed to be removed from Life Esidimeni in six months.
“There was no reason to refuse a legal instruction,” she said, adding that in weekly meetings, Mahlangu did not allow officials to disagree with her, threatening them with firing.
She said she did not have the power to stop the project. Still, she encouraged organisations like the South African Society of Psychiatrists to write letters to Mahlangu and former Gauteng health HOD Dr Tiego Barney Selebano about their unhappiness.
The inquest aims to determine whether anyone can be held criminally liable for the deaths of 141 mental healthcare patients, who died after being moved to NGOs from Life Esidimeni facilities.
Earlier, Manamela said it was not her responsibility to ensure that NGOs taking in patients from Life Esidimeni were up to standard.
According to a Netwerk24 report, she said she signed the licences for the NGOs but it was not her responsibility to identify the NGOs or to ensure that they were compliant. That was the work of her team, including deputy director Hannah Jacobus, she added.
Asked what her role was, Manamela said she had to provide support for the project and write progress reports. She further testified that she learnt about the cancellation of the Life Esidimeni contract for some 2 000 patients for the first time through the media while she listened to the budget speech of then Health MEC, Qedani Mahlangu, reports LegalBrief.
Manamela had told the inquest earlier that she was surprised by media reports in 2014 about plans to terminate the Life Esidimeni contract, and that the proposal to terminate the longstanding contract also came amid plans for community mental health services.
The media reports followed the budget speech where then-Health MEC Mahlangu presented the plan, citing financial constraints in the department.
EWN reports that Manamela said the first meeting was held in 2015 in Waverley, where Life Esidimeni executives joined Manamela and Mahlangu, and where two options were discussed. These included the transfer of some patients to other facilities and that patients who were going to be discharged would be sent to their families.
Manamela said it was at this first meeting that the patients’ families already disapproved of the proposal. “But the MEC explained there was nothing more we could do,” she said.
Two other meetings were held with the families.
Manamela said teams were then dispatched to assess the NGOs identified by the five districts, before the transfer project began.
More than 20 patients died at Precious Angels, the highest death toll at a single facility. Some patients were also taken from the Life Esidimeni facilities and placed at state hospitals. Two patients died at Weskoppies, while a staggering 13 died at Cullinan Care and Rehabilitation Centre.
Netwerk article – Director finally testifies, denies responsibility (Restricted access)
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Health managers point fingers at politicians in Life Esidimeni inquest
Life Esidimeni: arrest warrant for former mental health boss after non-appearance
Life Esidimeni inquest: ‘He vomited for four weeks and then he starved to death’