A mental healthcare patient crisis is looming in KwaZulu-Natal, with the province’s oldest and largest non-profit organisation teetering on the brink of bankruptcy.
Durban and Coastal Mental Health, which is funded primarily by the provincial departments of health and social development, interfaces with more than 600,000 patients every year who either live in its hostels, or attend “daycare” facilities or workshops.
But its recent financials show it is R6m in the red, “technically insolvent”, is being sued for about R2.4m for an unpaid bill from a service provider, and those attending the AGM last month were told there is only money for salaries for the next six months.
Some regular donors, concerned at the state of the balance sheet, are withholding funds and several sources told Sunday Times Daily they fear a looming “Life Esidimeni” situation if the NPO shuts down.
Already standards of care and food at the hostels have deteriorated, relatives of patients said.
And while some put the blame on a new board, elected only a year ago, it said it has unearthed wrongdoing by the previous board and inherited a financial mess.
According to the financial statement for 2018/19, the old board reported a surplus of almost R62,000.
At this general meeting the old board stepped down after disruptions and threats of legal action by a group of 27 parents, relatives and legal guardians who said the 78-year-old NPO was being mismanaged by “the Big 7” – board members who had dominated positions since 2012 and become a “reigning elite”.
The attorney representing this group, Sipho Shezi, then became the chairperson of the new board, which terminated the services of the usual auditors.
The latest annual statements, reflecting the deficit, were prepared by an accountant who reported that in terms of the NPO Act he was not required to do an audit or verify the accuracy of the information given to him by the organisation and he could not vouch for it.
The board introduced cost-saving measures — one of which was to get rid of the company providing meals at some of the hostels, which were delivered, ready made, and just had to be heated.
Charmaine Maas, whose sister is a resident at one of the hostels, said the meals were now being cooked on site and it was a “disaster”.
“The meals are dreadful. The kitchen staff are not qualified chefs. The residents are barely eating. They get no fruit or vegetables, and little protein. They are not getting the necessary nutrients and they are getting boils,” she said.
Maas said staff had not been paid for some months during lockdown. Some had stayed on, but others had left. One security guard had written on his time sheet: “If you are stealing my money I hope you get caught one day.”
Maas said telephone lines at the hostel were not working and she believed there was an outstanding Metro bill running into millions of rand.
Responding to questions, Shezi said the new board, acting on recommendations from the provincial department of health, had instigated a forensic investigation into historic “improprieties and shortcomings”, which was at an advanced stage.
He said government funded about 67% of revenue and there were “continuous discussions” about the financial status of the organisation.
“We have a recovery plan in place. Had it not been for Covid-19 we would have been much further with its implementation.
“Since we took over 12 months ago, we have been constantly doing this crisis management. The organisation was already sinking financially."
Shezi said the new board had implemented department of health recommendations — to improve security and hire nurses to administer and provide medication — fearing it would lose department funding if it did not and hoping for an increase in funding, “which we have been pleading for so that we can avert an Esidimeni kind of situation”.
However, he said, the residents were being well looked after, “as we have improved their care”. He said they were given “fresh, cooked meals on a daily basis”.
One of our main priorities as a department is to ensure that patients’ access to care is not compromised.
— Ntokozo Maphisa, KZN department of health spokesperson
Spokesperson for the KZN department of health Ntokozo Maphisa said the department was concerned about the “alleged goings-on at this facility”.
“We are currently still conducting an investigation into challenges that have been identified and will be meeting with management of this facility in due course to deliberate on these matters. One of our main priorities as a department is to ensure that patients’ access to care is not compromised.”
KZN social development spokesperson Mhlaba Memela said the department had embarked on an internal investigation, responding to a “series of incidents with regards to the ill-treatment and their failure to meet norms and standards set out in the service level agreement”.
“The document is in the process of being shared with the leadership and necessary action [will] be taken in that regard," he said.
“The department is aware of the challenges, but we have continuously funded the organisation, regardless of budgetary constraints that are being experienced by all government departments.”
This financial year, it had budgeted about R14.5m to fund two residential facilities, eight protective workshops, social worker and administrative posts.
He said the NPO also received funding from the department of health, Sassa, through grant in aid funding and a portion of social grants received by end users.
