Gauteng Premier David Makhura on Monday launched a scathing attack on his province's Department of Health over the move of psychiatric patients from Life Esidimeni to non-governmental organisations (NGOs), and promised an inspection of all facilities caring for the most vulnerable in society.
"Learning from this tragic death of mental health patients, I have decided to institute a wide-ranging inspection and condition assessment of all centres that care for the most vulnerable — the elderly, people with disabilities and children — whether they are operated by the public, private or NGO sectors," said Makhura in his State of the Province Address on Monday.
"It is our responsibility as the state to care for the weak.
"Every institution that provides services to the most vulnerable must meet appropriate standards. We cannot wait for another tragedy before we take wide-ranging action. The Life Esidimeni tragedy must spur us into action over the next two years to restore the dignity and human rights of mental health patients and all vulnerable groups in our communities. I am determined to lead this mission over the next two years of my term of office as the Premier of this province. I will appoint the Premier's Mental Health Advisory Panel to assist in this mission," promised Makhura.
He dissociated his office and executive from responsibility for the disaster.
"I would like to state categorically that the decision to transfer Life Esidimeni mental health patients to NGOs was not made in consultation with the provincial executive council. The executive council and I would have never approved a plan to outsource mental health, a primary responsibility of the state to care for the vulnerable in society, to NGOs. What is even worse is the fact that such NGOs didn't meet appropriate standards and legal prescripts," said Makhura.
At least 100 psychiatric patients died after they were moved from Life Esidimeni to NGOs as the provincial Health Department tried to cut costs. Health Ombudsman Malegapuru Makgoba in his report found that all 27 of the NGOs that the department had identified and moved the patients to were operating with invalid licences. He said, therefore, that all patients who died in these NGOs died in unlawful circumstances. Makgoba said the facilities did not have basic competence and experience, the managerial or leadership capacity, the "fitness for purpose" and were often poorly resourced. He said the NGOs had to be closed down.
Makhura said the transfer of patients compromised their wellbeing and he would ensure there is restorative justice for the families and that trust in the health system is restored. Makhura said the tragedy must be a lesson to ensure that the dignity of mental patients is restored, and said that the department should have placed the patients in public hospitals.
"It is common cause that the ill-fated transfer of patients to the NGOs compromised the wellbeing of mental health patients. At the very least, the department should have placed all patients in public health facilities or retained the services of private facilities in case there was not sufficient space in the public sector. As the head of government, I am deeply aggrieved by the extent to which those responsible for this tragic and ill-fated transfer of patients to unlawfully operating NGOs have tried to hide the facts from me, the Minister of Health and the Health Ombud," he said.
Makhura added that the provincial department repeatedly reported that, as a result of the new hospitals and community health centres, they had enough beds in public health facilities that could accommodate public patients from private health facilities such as Selby Hospital and Life Esidimeni centres. That was however not the case as some of the NGOs were said to have struggled to even buy food to feed the patients.
Makhura said they have been working closely with the affected families and they have asked that the situation should not be used for scoring political points.
"We are also working very closely with the families to deal with all the issues in the Health Ombud report. On Saturday, we hosted a healing ceremony for the affected families and this was a heart-rending moment for all of us. We will erect memorial stones at the Freedom Park in honour of all those who passed on. The Life Esidimeni tragedy must spur us into action over the next two years to restore the dignity and human rights of mental health patients and all vulnerable groups in our communities," he said.