100 Gauteng psychiatric patients still in NGOs

I am concerned at the report today that about 100 psychiatric patients in Gauteng are still at NGOs that are not equipped to care for them.

All the mental health patients that were transferred last year from Life Esidimeni were supposed to have been transferred to licensed facilities by the end of April according to an agreement by the Gauteng Health Department with the Health Ombudsman who had originally specified a 45 day deadline when he tabled his report on 1 February this year.

My information is that there are enough beds for the patients at the Selby Park Hospital and at the Esidimeni Waverley facility in Germiston which has been reopened.

The Gauteng Health Department should give a full report as to why it has not met the extended deadline for the transfer of patients, including the numbers of patients at the various NGOs and why they are still there.

I am also concerned by the slow progress into holding accountable the perpetrators of the more than 100 patients who died and also the failure to appoint a credible prominent person to lead the recommended Alternative Dispute Resolution procedure for redress and compensation to relatives.

Every effort should be made to comply with the Ombudsman’s recommendations following the terrible harm caused by the callous transfer of patients from Esidimeni to unsuitable NGOs.
 
Media Enquiries

Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222

Life Esidimeni patients still at unlicensed NGO’s

 

Fifty-nine days have passed since the Health Ombudsman released his report on the deaths of mental health patients who were transferred from Life Esidimeni.

 
In his report, Professor Malegapuru Makgoba recommended as follows:
“All patients from Life Esidimeni currently placed in unlawful NGOs must be urgently removed and placed in appropriate Health Establishments within the Province where competencies to take care of their specialized needs are constantly available, this must be done within 45 days to reduce risk and save life; simultaneously, a full assessment and costing must be undertaken.”

 
This 45-day deadline was passed two weeks ago, but the majority of Esidimeni patients, perhaps as many as 500 patients, are still with the NGOs.

 

I acknowledge the difficulty in finding alternative suitable facilities and to move with due care in not repeating the failures in the previous transfers of patients, but we need to be kept up to date with the transfers.

 

It appears that the Selby Park Clinic and Life Esidimeni facilities will take most of the patients but need time to prepare properly for this.

 

The Gauteng Health Department should disclose the full reasons for the delay and a timetable for the transfers to be concluded as soon as possible.

Media Enquiries

Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222

Deadline Not Met For Transfer Of Esidimeni Patients

The 45 day deadline by the Health Ombudsman looms today for moving more than 700 patients from unlawful NGOs to facilities where they will receive proper care and treatment.

In his report, Professor Malegapuru Makgoba recommended as follows:

“All patients from Life Esidimeni currently placed in unlawful NGOs must be urgently removed and placed in appropriate Health Establishments within the Province where competencies to take care of their specialized needs are constantly available, this must be done within 45 days to reduce risk and save life; simultaneously, a full assessment and costing must be undertaken.”

According to a statement last week by Gauteng Health MEC Gwen Ramokgopa, only 63 patients had been moved from two NGOs.

The main alternatives for the patients are the Selby Park Clinic and re-opened Life Esidimeni facilities.

It seems that 20 unlicensed NGOs are still looking after hundreds of patients.

Life Esidimeni has indicated that it would take a number of weeks for them to safely accommodate a large number of the patients.

Ramokgopa has said that R495 per day is being paid for each patient at the private facilities, which amounts to about R15 000 per patient per month.

This is considerably higher than the R320 per day that was paid previously to Life Esidimeni, which amounted to R9920 per month for each patient.

It highlights once again the folly of former Health MEC Qedani Mahlangu in cancelling the previous contract with Esidimeni after a study by the Health Advance Institute in May 2015 found that this was good value for money.

I appreciate the care that is now being taken to involve relatives in the transfer to new facilities, but I am concerned that so many patients remain in unlicensed NGOs.

At least two more patients at these NGOs have died since the release of the Ombud’s report on 1 February.

We need more transparency about the reasons for the delay and a timetable for the transfers to be concluded as soon as possible.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Gauteng Health Department Ignored Report That Could Have Saved Esidimeni Patients

Health Advance Institute Report

A report commissioned by the Gauteng Health Department in May 2015 found that the service provided by Life Esidimeni (LE) for psychiatric patients was “good value for money” and made recommendations that were ignored concerning the monitoring of patients transferred to NGOs.

According to a written reply by Gauteng Health MEC Gwen Ramokgopa to my questions in the Gauteng Legislature, the report was done by the Health Advance Institute (HAI) which was asked to evaluate the cost of LE’s services and to evaluate the appropriate daily tariff per patient.

The report cost R410 500 and was sent to the department on 22 May 2015.

HAI found that the profit over all LE’s facilities in 2014/15 was R29.85 million (13.8%) on a turnover of R215.74 million, which was considerably lower than the 28% average profit by health companies on the JSE at that time.

Instead of a predicted average cost of R320 per patient per day in the five LE facilities for 2260 patients, the actual cost was R262 per patient, which was 22.6% lower than expected.

The report says that “LE low costing is probably due to a combination of low infrastructure costs, large number of patients per unit, patients treated in groups rather than individually, below expected staffing levels and efficient management.”

According to HAI “there is generally substantial compliance with the terms of the Service Level Agreement (SLA) within the following areas: patient cleanliness, nourishment of patients, good relation between patient and staff, treatment and care.”

They did note, however, some areas for review, including:

– a dischargeable status within one year was not met that was a requirement of the SLA and may not be achievable
– no record of milestone observed in the patients file
– limited explanations on the management of treatment to the patients and family
– upholding the responsibility to try to find alternative accommodation for all the patients
– setting up an appropriate M & E system

The report concludes as follows:

“In general the service provided by LE is good value for money. HAI believes that sufficient and relevant information has been obtained to enable the Gauteng Department of Health to make sound and evidence-based decisions with regards to the future financial planning and management of this SLA.”

Former Gauteng Health MEC Qedani Mahlangu

Suggestions were also made, including the following:

– establish task team to define the minimum standards required … in selection of the new places or alternative accommodation
– urgent inspections and reporting on each of the facilities to which patients were distributed after termination of the LE contract in relation to the norms and standards as defined by the task team
– to withdraw and re-accommodate any patients who are in sub-optimal conditions
– establish regular monitoring inspections at all facilities where patients are to be managed.

On the basis of the report, the department granted a tariff increase as requested by LE.

This report undermines the claim by former Gauteng Health MEC Qedani Mahlangu that LE was overcharging and that the contract was terminated because of high cost.

Furthermore, the recommendations concerning monitoring of patients sent to other facilities were ignored, which led to the tragedy of more than 100 deaths as found by the Health Ombudsman.

It is further evidence of gross negligence by Mahlangu and senior officials that should lead to a conviction of culpable homicide in a court of law.

 

 

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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NGO Threatens Brother Of Deceased Patient

Shammah House NGO

I am appalled that the Shammah House NGO has threatened the brother of a deceased mental health patient who was sent there from Life Esidimeni last year.

Mr Mike Thlolwe (60) died at Shammah House in Cullinan on 12 February this year shortly before an ambulance was to take him to hospital.

Last week on Thursday the NGO sent a letter from a law firm to his brother Ike Thlolwe threatening him with legal action if he did not retract public statements blaming them for poor treatment of his brother.

Health Ombudsman’s Recommendation

According to the legal letter “Our instructions are that our client attended to your brother’s health and welfare according to best practice and followed every relevant protocol … Our client reserves its rights to take any legal action should they become aware of any untrue, unfounded or defamatory statements or insinuations in respect of their conduct.”
Shammah is acting in a very inappropriate and insensitive manner.

I have reported this to Gauteng Health MEC Gwen Ramokgopa and requested her to intervene to resolve this matter.

I am also concerned that Shammah has reportedly been offered a contract by the Gauteng Health Department to continue to accommodate 44 mental health patients.

This is despite the Health Ombudsman’s recommendation that former Esidimeni patients be moved from the unlicensed NGOs.

We need to know that all mental health patients are in suitable facilities that are regularly monitored by health officials.

 

 

Media Enquiries
 
 
 
Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222
 
 
 
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Esidimeni Death Toll Rises

I have been informed of another death of a patient transferred from Life Esidimeni to the Shammah NGO based in Cullinan.

According tohis brother, he died this week and was in an emaciated condition.

This gives urgency to the need to close down the dodgy NGOs and transfer the patients to decent facilities as recommended by the Health Ombudsman in his report on 94 previously identified deaths.

Delays in transferring patients should not add to the immense tragedy of avoidable deaths in this whole sorry saga.

The final death count is likely to be well over a hundred as Health Minister Aaron Motsoaledi noted yesterday that there were 19 unidentified bodies in mortuaries from NGOs where Esidimeni patients were transferred.

I welcome Motsoaledi’s announcement that 22 of the 27 NGOs will be closed based on the assessments of the expert team that he has assembled in this matter.

He also said that seven facilities had already been closed down, including the two Rebafenyi facilities associated with Police Major-General Sandra Malebe-Themba and Tshwane ANC councillor Nosipho Makeke-Tyobeka.

I think it is good that the private health sector will also be used for the patients, including the re-opening of Life Esidimeni facilities in a phased manner. This is necessary because existing state facilities are already over-crowded.

Another positive is the Minister’s commitment to involve the families in approving the appointment of a prominent person to lead the Alternative Dispute Resolution Process as recommended by the Health Ombudsman for healing and redress.

The DA will monitor the implementation of the Ombud’s recommendations which need to be completed within the 45 day deadline.

It is important that the public is kept informed of all steps taken in this tragic matter, including criminal charges that should be laid against all those implicated.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

ANC Councillor And Police General Implicated In Unlicensed Premises For Psychiatric Patients

Police Major-General Sandra Malebe-Themba

I have established that a ANC councillor and a police general are involved in a NGO which looked after more than 100 psychiatric patients transferred from Life Healthcare Esidimeni at two unlicensed premises in Tshwane.

Police Major-General Sandra Malebe-Themba is the Executive Chairperson of the Re-Bafenyi Victim Empowerment Centre (RVEC) which is a NGO based in Atteridgeville that was established in 2011. Its primary purpose is to provide a safety net to all victims of domestic violence and abuse.

But Rebafenyi Mental Health is a recent programme added by RVEC which says in a presentation had two 24-hour operational centers:

– At Hennops River with 59 beneficiaries
– At Phelindaba (Schuverberg) with 60 beneficiaries

Tshwane ANC councillor Nosipho Makeke-Tyobeka

Tshwane ANC councillor Nosipho Makeke-Tyobeka is listed as a committee member of Rebafenyi Mental Health. At the time she was the MMC for Sports, Recreation and Arts
and Culture and states in her profile that she is a member of the ANC Women’s League.

Last year in November I pointed out that the Rebafenyi facility in Hennops River was blatantly contravening municipal by-laws. This was according to a report by the Tshwane Health and Social Development Department which investigated the NGO after complaints received by DA Councillor Kingsley Wakelin that people living there were jumping the fences and disturbing the neighborhood.

The Health Ombudsman found that neither of the two Rebafenyi facilities were operating with legal licenses and the patients have since been transferred elsewhere.

Christopher Mogwarane

Christopher Mogwarane (56) was one of the patients transferred to Rebafenyi in Hennops River from Esidimeni and died there. According to his brother Lucas, he was not happy there and he did not appear to be getting proper nutrition and medication.

There were fortunately no deaths at the Phelindaba facility, but the patients were unexpectedly placed there in June last year by Rebafenyi and the owners placed signs saying they were not legally liable for anything that happened to them.

I suspect that money was the motivation for certain NGOs taking psychiatric patients that they could not care for properly.

Refanyeni was paid R2700 per patient per month, so it got about R270 000 a month for patients.

Investigation into Money Flow

It is shocking that a senior ANC Councillor and a police general are involved in a dodgy NGO with unlicensed premises in which one patient died, possibly from neglect.

General Malebe-Themba resigned from the police in 2013 after a misconduct probe but was re-employed after acting commissioner Kgomotso Phahlane took office in 2015. She is currently facing a complaint of racism.

There should be an investigation into the money flows and who personally benefited at all the NGOs where Esidimeni patients were placed.

Criminal charges should be pursued in cases where money was diverted into private pockets while patients were neglected and their lives placed at risk.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

DA Lays Charges Against Former Health MEC Qedani Mahlangu

Former Gauteng Health MEC Qedani Mahlangu

The DA is laying charges today against former Gauteng Health MEC Qedani Mahlangu who resigned this week after the devastating findings of the Health Ombudsman’s report into the transfer of mental health patients from Life Healthcare Esidimeni to NGOs without legal licenses where 94 patients died.

In my affidavit, Mahlangu is charged with culpable homicide and with contraventions of the Mental Health Care Act (MHCA) and the National Health Act (NHA).

Click here to view the affidavit.

Culpable Homicide

The crime of culpable homicide is defined as the “unlawful, negligent killing of another human being.”

The Ombud’s Report in numerous instances describes the conduct of the Gauteng Department of Health (GDoH) and by extension the MEC, as negligent. There can be no doubt that the deaths of the patients are as a direct consequence of that conduct, and that the conduct was not in accordance with the NHA, the MHCA and the Constitution.

It is therefore apparent that the MEC, in instructing the termination of the GDoH contract with Life Healthcare Esidimeni, has prima facia met the requirements of culpable homicide.

Section 70 of the MHCA states as follows:

“(1) Any person who – 

(a) misrepresents a fact in any application, report, record, certificate; 

(b) obstructs or hinders any person in the performance of his or her functions; 

(c) neglects, abuses or treats a mental health care user in any degrading manner or allows the user to be treated in that manner; 

…. is guilty of an offence.

The MEC’s false statement in the Legislature on 13 September 2016 in which she said that 36 patients had died whereas the true figure was 77 patients is a prima facie misrepresentation of a fact in a report as considered by Section 70(1)(a) above.

Life Healthcare Esidimeni

Furthermore, the decision by the GDoH to terminate its contract with Life Healthcare Esidimeni at the MEC’s instruction directly resulted in the neglect and abuse of numerous mental health care users. Instigating such treatment, let alone permitting it, is therefore a prima facie offence in terms of Section 70(1)(c).

I also charge the MEC with breaches of the NHA that relate the withholding of adequate health services as required in Section 3(2) and also the failure to provide discharge reports as required in Section 10.

I have laid these charges as it is important that there are consequences for contraventions of the law by politicians and also because I am not confident that the provincial government will lay similar charges against former MEC Mahlangu.

The scale of the deaths and the negligence make this a Medical Marikana that requires accountability from the perpetrators and justice for the victims.

Media are invited to the Johannesburg Central Police Station at 1 Commissioner Street at 12pm where I will be formally laying the charges.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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DA Welcomes Resignation Of Gauteng Health MEC

Health Ombudsman’s Report

I welcome the resignation of Gauteng Health MEC Qedani Mahlangu in the wake of the highly critical findings of the Health Ombudsman concerning the deaths of at least 94 mental health patients.

Premier David Makhura bears part of the blame for this disaster as he should have acted earlier to fire her and taken action to protect the patients, many of whom are still suffering in unsuitable NGOs.

Dr Gwen RamokgopaDr Gwen Ramokgopa

It took 141 days for Mahlangu to resign following the first disclosure of deaths in reply to my question in the Gauteng Legislature on 13 September last year.

I am not impressed with the return of Dr Gwen Ramokgopa as MEC of the Gauteng Health Department. She was mediocre in this position previously and does not have the drive to fix this deeply dysfunctional department.

Premier Makhura has failed badly in this matter and needs to keep his promises to ensure that action is taken against all those implicated, including criminal charges.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Premier Must Take Stern Action Over 94 Patient Deaths

Health Ombudsman’s Report

I am shocked to the core by the revelation today by the Health Ombudsman that 94 psychiatric patients died (and possibly more) after their transfer last year from Life Healthcare Esidimeni.

Health MEC Qedani Mahlangu lied to me in the Gauteng Legislature on 13 September last year when she said that 36 patients had died in the NGOs in which they were placed. Health Ombudsman Malegapuru Makgoba said that on that date 77 patients had already died.

Premier Makhura has to fire Mahlangu and ensure that disciplinary action is taken against the 11 senior health department officials identified in the report.

Criminal Charges

Criminal charges should also be laid against all implicated parties including those in the five NGOs where 80% of the patients died.

Premier Makhura must also ensure that immediate steps are taken to ensure the safety and well-being of all the patients who are still with the NGOs.

Makura’s image has taken a severe blow because of his failure to fire Mahlangu earlier and to replace her with a competent and caring Health MEC.

This is a crisis for the ANC in Gauteng and all those who failed to act earlier against Mahlangu.

I will study the full report and monitor the actions based on its findings.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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