From page 1 Mahlangu’s confidante said they had expected Makgoba to consider these figures during his investigation.
“But he chose to ignore this and only look at what led to the deaths of the patients. While there were some errors made by [provincial government] departments, Professor Makgoba should have taken into consideration that this project was in the best interest of the patients and the state,” the confidante said.
“The former MEC was also under pressure from the Auditor-General to review indefinite or long-standing contracts with service providers.
“The Office of the Auditor-General highlighted that a review of various contracts, including that of Life Esidimeni, could result in cost savings.”
However, Makgoba told City Press on Friday that the patient death rate at Life Esidimeni – between three and four for every 100 patients – was significantly lower than those of the NGOs, where at least seven out of every 100 patients died.
Patel said patients with severe mental health disorders lived 10 to 25 fewer years than the general population, and that “almost all deaths occurring between 2011 and 2016 ... at Life Esidimeni were due to chronic physical medical conditions such as cardiovascular, respiratory and infectious diseases, diabetes and hypertension”.
WHY THE NATIONAL DEPARTMENT DID NOT INTERVENE
City Press has learnt that the national health department tried to intervene in 2015, when Mahlangu initiated the Gauteng Mental Health Marathon Project.
But the provincial department allegedly told senior national officials – including director-general of health Dr Precious Matsoso – to butt out because it was responsible for implementing policies in the province.
A senior national official told City Press this week: “Dr Matsoso and noncommunicable diseases cluster manager Professor Melvyn Freeman tried in vain to get the plan detailing how mentally ill patients were going to be moved from centres owned by Life Esidimeni to various NGOs.
“Matsoso was told by Gauteng’s health department head not to worry because ‘we have a plan and that plan was approved by the court’.
“When she requested to see the plan, it was never sent to her. The same situation was experienced by Freeman. Both were simply reminded that it was the MEC’s competency to implement any plan.”
The senior official said the “concurrent competencies” of national and provincial departments were a major problem.
“Some provinces in this country do what they like. They never listen to national government because the National Health Act gives powers to MECs to run health,” said the senior national official.
“Each time they will remind you that it is their competence to implement policies developed by [the] national [department], and how they do it does not really concern the national government.
“We saw this in Gauteng and we were about to see it in the Eastern Cape as well. MECs do what they like; the minister or the director-general has no say.” Motsoaledi agreed. “I am the minister of health, responsible for the lives of South Africans, but I do not have authority over how provinces implement policies,” he said.
Motsoaledi said he would investigate changing the National Health Act and the Mental Health Act, as Makgoba had recommended in his report.
“What I need to do now is send a message to all the MECs and premiers to tell them: ‘Do not embark on any decisions, even though you think you have authority, until I give an express approval,’” he said.