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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”.


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.

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