Mahlangu told me that number of patient deaths was ‘normal’, David Makhura tells Life Esidimeni inquest

Former premier of Gauteng David Makhura told the Life Esidimeni inquest in the Pretoria high court that then MEC of health Qedani Mahlangu and her team justified the deaths of the mental health patients, saying it was not unusual compared to previous years.

The inquest will determine if anyone can be held criminally liable for the deaths of 144 mentally ill patients. The Gauteng government in 2016 moved about 1,500 psychiatric patients from the licensed Life Esidimeni facility to 27 unlicensed NGOs.

Makhura was 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.

He said he was called to a meeting with Mahlangu, who brought her team to explain.

“I was quite 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. What they basically did was tell me over the past five years how many mental health patients have died. I was shocked that in some years we would have 30 and other years close to 40. They said this is a trend that has been going on for the past few years.

“According to them, the passing of mental health patients in the NGOs was not unusual; it was normal.

“I issued a statement afterwards. In the statement I dealt with this part of the deaths. I probed them on how they ended up in the NGOs.”

He said one of the explanations given that made him doubtful was that the department was implementing the national health policy framework and strategic plan from 2013 in which deinstitutionalisation of patients is recommended. This advocated for patients to be placed in community facilities and institutions closer to communities.

“This was in pursuit of this plan,” Makhura said.

“I had doubts about their explanation. I had to consult with the national health department. I phoned the minister and we met. The minister said he has appointed an advisory committee and he had instructed the health ombudsman to investigate.

“He made it clear what the department was implementing was not in line with the policy. It requires processes. At that time I was satisfied. From there we worked with the minister.”

In her evidence at the inquest, Mahlangu said a budget committee led by Makhura made the decision to terminate the department’s contract with Life Esidimeni, the facility where mental health patients had been receiving care. She also implicated former MEC for finance, Barbara Creecy.

Makhura said the main task of the premier’s budget committee is to make sure resources are aligned in accordance with priorities.

“They presented this to the PBC and they were still going to do some work. The PBC didn’t have a problem with what they were proposing. The presentation was not rejected by the PBC.

“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 completely 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 instead had been underspending its allocated budget.

“There was no cut in the health budget between the financial years,” she said.

TimesLIVE