EDITORIAL | As the wheel of justice grinds slowly for Esidimeni victims, we hope it grinds fine

It has been seven years since the Gauteng public health system neglected and starved mental health patients from Life Esidimeni in a rushed move to unscrupulous centres. For the past week, then MEC of health Qedani Mahlangu has been grilled at a high court inquest into criminal liability related to the deaths of 144 psychiatric patients.

There has been a lot movement on the matter over the years with more than R400m paid out to the families of the victims, but more money might be paid out as a result of the tragedy. In this case, progress, though slow, is still progress. But with the inquest we are reminded again how slow the wheels of justice turn. Even if criminal liability is established, there is no saying how long that prosecution will take. This is also a complicated matter involving many parties and many lawyers, again slowing down the quest for justice for the bereaved families.

In her evidence, Mahlangu insisted the decision to close Life Esidimeni was to curb spending in the department and save more than R300m.

“I would like to repeat that we were not going to throw any patients away. We are saving the R300m that we are spending at Life. 

“If we have R300m to pay for these patients, great, let’s go ahead with the contract. But we don’t have the money,” she said. 

Mahlangu's testimony focused on distancing herself from any liability. She would often waste time with unnecessary background on departmental protocols and repeatedly failed to answer questions succinctly.

Presiding judge Mmonoa Teffo had to reprimand her and remind her to stick to the questions asked. As a result, the inquiry has dragged as exasperated family members watch helplessly.

South Africa is a country obsessed with commissions of inquiries and inquests drawn from best legal practice — and rightfully so, but they often drag and waste much-needed public funds.

Mahlangu rested her evidence on statements that she had put her full confidence in the department’s team and her responsibility was merely to execute and not request a further extension of the contract with Life Esidimeni.

If she had paused, as a good manager and public servant should, and taken some time to question the wisdom and impact of the move, she would have saved lives. She has since admitted the move could have been handled differently, but this introspection should have come much sooner. 

South Africa is a country obsessed with commissions of inquiries and inquests drawn from best legal practice — and rightfully so, but they often drag and waste much-needed public funds. The state capture inquiry is an example of how, by the time the inquiries are concluded and recommendations are made, there is little left to rescue.  

The country is still grappling with inadequacies when it comes to mental health care in general. In fact, at the mental health conference held by minister of health Dr Joe Phaahla last month, he said all provinces ha adt least one facility rendering services for people with dual diagnosis except Mpumalanga as there is no specialised psychiatric hospital in this province. Mpumalanga refers people requiring this service to Gauteng.   

Before 1994 under the Mental Health Act of 1973, mental health services were unevenly distributed and resourced. Phaahla said the focus was on medically subduing the symptoms and institutionalising individuals in isolated specialised psychiatric hospitals with very little focus on human rights and psychosocial rehabilitation. 

The health minister should be applauded for making an effort to raise awareness around the matter and for trying to improve offerings in under-serviced provinces. The health department needs to ensure these plans are executed, and, even better, within the time frames they have set for themselves. This way, we are looking forward and not back.

However, those who cancelled the Life Esidimeni contract must be held criminally liable, no matter how long it takes.