Costly care cuts

THE People’s Health Movement South Africa applauds health ombudsman Malegapuru Makgoba’s report into the circumstances surrounding the deaths of mentally ill patients in Gauteng in 2016.

The subtitle of the report – “No guns: 94+ silent deaths and still counting” – is highly appropriate in the light of the chilling findings of the investigation.

The revelation that at least 94 mentally-ill patients died after being moved from Life Esidimeni to 27 unlicensed NGOs that did not have the capacity to provide the care they needed is shocking.

The ostensible reasons for this action – to save money and in this case it was in line with the international trend to de-institutionalise psychiatric patients – do not justify the wilful mistreatment of long-term mental health patients for short-term gain. They reflect a preoccupation with efficiency ahead of patient rights and social justice.

In March 2016, while the Gauteng health department was under curatorship, the MEC, Qedani Mahlangu, said; “We will do everything possible to our powers that we stretch the rand even further, we do things that matter and we eliminate any inefficiency in the system.”

However, it seems all that mattered to MEC Mahlangu and her senior officials was to reduce costs. Costcutting in health care can be life- threatening when it is implemented without regard for human dignity.

There were also many desperate attempts by families and advocacy groups like the SA Society of Psychiatrists and the SA Depression and Anxiety Group to convince them of the danger. Even litigation failed to convince them. The People’s Health Movement South Africa calls for:

The investigation into this shameful episode to continue until its full extent is clear to the nation.

Full accountability from all those responsible for these deaths – from those who ordered the placements in unregulated settings to those who operated these “homes”. Appropriate punitive steps. Mahlangu’s resignation, though welcome, does not absolve her from full accountability. We consider this especially important in the light of the fact that other provinces may be considering similar activities.

Finally, we call for a commitment from the state towards a single, adequately resourced and equitable National Health System that recognises our common humanity and provides high quality health care for everyone according to need, irrespective of social status or means.