The Life Esidimeni inquest has heard how mentally ill patients at one of their facilities had 15 nurses caring for about 600 patients, as former staff faced questions on whether mentally ill patients had been adequately looked after.
An IOL report notes the inquest is probing whether anyone should be held criminally liable for the deaths of 144 patients who died after being moved to various Gauteng NGOs.
Zanele Buthelezi, a former nurse at Waverley Care Centre – one of several Life Esidimeni facilities housing mentally ill patients – gave evidence this past Monday (6 September). Legal representative of the former head of mental health in Gauteng, Dr Makgabo Manamela, asked Buthelezi how many patients were housed at the facility. She said the number was 580, but other records show it to have been 604. Buthelezi also confirmed that 15 nurses worked at the facility and admitted that this fell far below the required number.
Buthelezi said this number would increase depending on how many nurses were on duty. She said she was not in charge of staff appointments, which were the responsibility of head office. The inquest heard that some relatives of patients who had initially been housed at Waverley objected to their families being moved to some of the NGOs. The families requested a meeting with former health MEC Qedani Mahlangu. They had gone to inspect some NGOs and were not pleased with the conditions.
Buthelezi told the inquiry she had witnessed Manamela accompanying NGO members to fetch patients from Waverley. Manamela has disputed this. Buthelezi also expressed concerns that the transfers were done in a rush. She said about 60% of Waverley's patients were not dischargeable or suitable for placement with NGOs.
The Life Esidimeni group has also denied over-charging the Gauteng Health Department for the care of its patients. Former MD Morgan Mkhatshwa said they offered the best care to patients at reasonable prices, according to a News24 report.
Mkhatshwa said for the 2012/2013 financial year, the Gauteng Health Department gave them an increase of 3%, resulting in a shortfall of R7.9m. Their financial difficulties were made worse by the department not paying them on time.
“There were times when the Department of Health didn't pay within the stipulated timelines… Life Esidimeni would have to apply for a subsidy from the mother company Life Care.” He said they were charged interest on the subsidies.
Mkhatshwa, on his last day of cross-examination, said tariff increases were calculated based on the CPI and salary negotiations with unions. The company spent about 53% of its budget on salaries.
He said a study by the Health Advanced Institute in 2015 found that Life Esidimeni rental and transport costs were reasonable. “We had tight controls and made sure that we were (as) cost-efficient as possibly can be. The needs for mental health users were met and I was comfortable with that.”
The cross-examination of Zanele Buthelezi, the former Life Esidimeni nursing manager, continued on Tuesday, according to a Daily Maverick report, where legal counsel for Gauteng Department of Health officials questioned her on whether the patients who were transferred from the Waverley Care Centre had left according to the conditions in Life Esidimeni’s service level agreement with the department. Buthelezi conceded it was the responsibility of Life Esidimeni to assess the health of the patients.
Nonceba Sennelo, the deputy director of mental health at the department, submitted that the patients were not handed over to the department but in fact directly to the NGOs where they had been placed, and that the department’s role was simply to sign off forms saying they had witnessed patients being transferred. Advocate Amanda Gxogxa, legal counsel for former department nurse Rochelle Gordon, told the inquest that Gordon would submit that there were patients who were meant to be moved into a hospital from Life Esidimeni Waverley but were moved to Tshepong NGO.
In response, Buthelezi said she was not in a position to account for the decision of the department to transfer patients in need of hospitalisation to NGOs after Waverley had supplied the department with the condition and resultant needs of patients. "We had patients who were frail at the facility. We had patients who were sick, and that is why we had a sick bay. If it was a condition we could not manage, they were transferred to a provincial hospital," she said.
News24 article – Life Esidimeni denies overcharging the Gauteng health department (Open access)
Daily Maverick article – Life Esidimeni inquest told of patients being transferred to NGOs despite ailing health (Open access)
See more from MedicalBrief archives:
Life Esidimeni deaths: ‘Not the fault of Health MEC’
Life Esidimeni: Search continues for 8 missing mental health patients
Asset Forfeiture Unit seizes property bought with funds ‘diverted from Life Esidimeni’