Former Gauteng Premier David Makhura told the Life Esidimeni inquest in the Gauteng High Court (Pretoria) this week that then-MEC of Health Qedani Mahlangu and her team justified the deaths of the mental health patients, saying the number was not unusual compared with previous years; that it “was normal”.
The inquest will determine if anyone can be held criminally liable for the deaths of 144 mentally ill patients after 1 500 of them were moved from the Life Esidimeni facility to 27 unlicensed NGOs in 2016, reports TimesLIVE.
Testifying on the deliberations of the Premier’s budget committee (PBC) meetings and subsequent steps taken after it was first announced the former Esidimeni patients had died, Makhura said he was called to a meeting with Mahlangu, who brought her team to explain.
“I was livid. We had 36 patients who died in our facilities. How does this happen? How did they die? Under what circumstances?” said Makhura. “The officials made a presentation, basically telling me how many mental patients had died over the past five years. I was shocked that in some years we would have 30 and other years close to 40. They said it had going on for years.
“According to them, the deaths of mental health patients in the NGOs was not unusual; it was normal.
“I issued a statement afterwards dealing with this. I probed how they ended up in the NGOs.”
He said one of the explanations that made him doubtful was one saying the department was implementing the national health policy framework and strategic plan from 2013 in which deinstitutionalisation of patients was recommended – for patients to be placed in community facilities and institutions closer to communities.
“They told me this was in pursuit of that plan,” Makhura said. “I had doubts. I had to consult with the national Health Department. I phoned the Minister who said he had appointed an advisory committee and instructed the Health Ombudsman to investigate.
“He made it clear what the department was implementing was not in line with the policy. At that time I was satisfied.”
In her evidence, Mahlangu said a budget committee led by Makhura made the decision to terminate the department’s contract with Life Esidimeni. She had also implicated former MEC for finance, Barbara Creecy.
Makhura said the main task of the premier’s budget committee was to make sure resources were aligned in accordance with priorities.
“They presented this to the PBC and …the PBC didn’t have a problem with what they were proposing. The presentation was not rejected.
“The PBC would be in no position to take a decision on a contract. It’s not something we had authority on. It doesn’t make decisions on contracts or procurement. It would be unlawful,” he said.
On Tuesday, Creecy told the inquest the health department was not under any pressure to cut costs when it terminated the contract and in fact instead, it had been underspending its allocated budget.
“There was no cut in the health budget between the financial years,” she said.
“The budget allocation to health in the financial year of 2014/15 was R31.4bn. In that financial year, there was underspending by the Health Department.
“In 2015/16, in the main adjustment, they received R34.1bn – a significant increase in budget. By the end of the financial year, they received R35.3bn in the adjustment budget. By the end of the financial year they had spent R34.8bn, and again, an underspending on the budget.
“The next financial year, R37.4bn was allocated and there was a slight underspending.
“In the 2017/18 financial year, R40.2bn was allocated and there was overspending at the end of the financial year: they spent R42bn. There was no cut in the health budget between the financial years,” she said.
Creecy said during the years under consideration, there was no decrease in the overall mental health budget.
“In that financial year (2013/14), R1.1bn was allocated for mental health services. The actual expenditure was slightly over R1bn, an underspending of R62m.
“The following year there was R1.1bn allocated, the expenditure came to R1.2bn – R47m over-expenditure. In 2015/16 we recognised the overspending and allocated R1.26bn to the department: the spending was R1.22bn, an underspending. The budget increased to R1.35bn, the actual spending was R1.27bn,” she said.
Two weeks ago, Mahlangu told the inquest that “the decision to terminate was made through the budget committee, and the premier was alive to all that was happening, including MEC Creecy”, but in her evidence, Creecy said the PBC directed the decision to end the contract.
See more from MedicalBrief archives:
R77m legal fees for Life Esidimeni inquest, and counting
Former MEC claims she was unaware of risks of Life Esidimeni transfers
Life Esidimeni inquest: MEC dodges blame for ending contracts