No excuse for hurry‚ says official on moving Life Esidimeni patients

Seven-hundred people lost their jobs after the Gauteng department of health ended its contract with three Life Healthcare Esidimeni facilities to look after around 1‚400 psychiatric patients.

The director of the project to move all psychiatric patients from their home‚ Levy Mosenogi‚ testified at the hearing on Tuesday.

Despite months of warnings about the risks of moving severely sick people into NGOs‚ including five letters from the SA Psychiatric Society and family and civil society‚ MEC Qedani Mahlangu made the decision to move more than 1‚400 patients from homes into ill-equipped NGOs. Mosenogi testified that 700 caregivers such as nurses and doctors at Life Esidimeni facilities lost their jobs but he couldn't say how many were rehired when Life Esidimeni was forced to close its doors.

He started the project to move patients in January and had to move 1‚400 or so very ill patients out by March.

Part of the urgency was the fact the contract with Life Esidimeni had been cancelled by MEC Qedani Mahlangu‚ he said.

He realised he would not meet the March deadline and got an extension till June as even Life Healthcare Group was saying it needed sufficient time to give staff retrenchment notices.

Mosenogi also admitted NGOs were not paid on time to look after and feed patients as there were not payment systems in place when patients were moved there.

Former deputy chief justice Dikgang Moseneke‚ the hearing judge‚ was at pains to find out why the Life Esidimeni contract was cancelled and why moving so many sick people was rushed.

Moseneke asked: “Why would you move people before processes to pay money were in place? What was the big pressure to do what you did?"

Mosenogi didn’t have an answer. “I don’t have an excuse why we had to hurry it …. My initial thought was it [the move] should be done in phases.”

But he said he was acting on instruction from the MEC Mahlangu and the then head of the Gauteng health department‚ Barney Selebano.

He also said that reasons for ending the Life Esidimeni project were "cost cutting" and because the auditor general asked questions about the same contract with the same supplier every year."

The Gauteng department of health had used Life Esidimeni to look after severely ill psychiatric patients for 30 years. "The auditor general issues [with us] are renewing one contract with one supplier all the time.” However‚ Mosenogi admitted no one had explained the 30-year contract with Life Esidimeni to the auditor general to address his concerns.

"I don't think he was approached [to explain] I don’t know whether anyone of us raised the issue with the auditor general."

Even though he was project manager‚ Mosenogi learned of the first reported 36 deaths through the media‚ which he could not explain.

He failed to answer questions such as when had the project ended?

“It didn't have an end point.”

He also could not explain how doctors and staff in the project decided which patients to move and which NGOS to place them in. There were 532 patients who were so ill they had been at Life homes for more than 10 years‚ but he couldn’t explain if these very ill people were properly matched to experienced NGOs.

He also testified that one Life Esidimeni Baneng house for intellectually disabled children was planned to be closed.

The children were initially also supposed to be moved to NGOs. He was able to ensure the children's contract was extended by a year‚ from last March. The contract remains in place.

"What went wrong?" asked Moseneke.

Mosenogi said: "The timelines for project were just not normal. We just could not do the [move] with the timelines we had been given."

He hinted that NGOs which were to be paid R112-a day for patients were supposed to find own money to subsidise this paltry sum from fundraising.

"A R112 is an addition to their own fundraising. They also get pension fund or [disability ]grants.

"The most established NGOs are able sustain themselves."