Overseeing NGOs is a core function of Hannah Jacobus’ job, but the Gauteng deputy director of mental health said she was only following instructions when she participated in the programme to send psychiatric patients from Life Esidimeni to the deadly NGOs where many of the 143 died.

Jacobus repeatedly blamed her boss, the province’s former mental health care director, Dr Makgabo Manamela for ignoring warnings and instructing officials to act illegally in order to move the patients into NGOs as quickly as possible, even if they did not have legitimate licences or the resources to care for patients with chronic mental illnesses.

The arbitration, led by former Deputy Chief Justice Dikgang Moseneke, entered its final phase on Thursday and will soon hear from former health MEC Qedani Mahlangu, Premier David Makhura and Health Minister Aaron Motsoaledi. Senior officials who have appeared have tried to avoid taking responsibility for the deaths and have passed blame on to their colleagues or superiors.

Jacobus implicated Manamela, who testified in November. She said her former boss told staff to ignore the protocol for issuing licences to NGOs where patients would be sent, meaning the facilities were not sufficiently screened. The arbitration has heard that the NGOs did not have the skills, staff, medical knowledge or basics like food and clothing to care for patients.

“I was instructed to continue in collating and compiling the licences because it was an unusual situation and there were time constraints due to the closure of Life Esidimeni,” she said. Jacobus said she told Manamela she was uncomfortable with fraudulently issuing licences, but she continued to do so when she was told it was a direct instruction.

“Why did you and Dr Manamela play roulette with people’s lives?” asked Moseneke. He said each official who has appeared at the arbitration “just runs away from responsibility”. After raising her concerns with Manamela, Jacobus did not put them in writing or speak out to other senior officials.

Jacobus’ testimony could be damning for Manamela. She said the former director directly issued staff to organise and backdate NGO licences that were illegal. Manamela denied she had personally gone to an NGO to arrange beds, but Jacobus said she was there with her hurriedly preparing the Siyabadinga NGO for patients.

The department did not pay NGOs for months after they received patients, worsening the conditions patients were subjected to. Jacobus said she tried to file the paperwork to ensure NGOs were paid but Manamela blocked her attempt, claiming there were other budgetary priorities. A contractor who delivered linen to the NGOs went bankrupt and lost his house due to non-payment, she said.

Manamela and her boss, former Gauteng health department head Dr Barney Selebano both resigned this week before their disciplinary hearings could begin. They avoided being dismissed by the province, which saved Gauteng from potentially hefty legal costs but allowed Selebano and Manamela’s official records to say they resigned rather than were dismissed.

File Photo: A photographic collage presented at the hearings by Section27 in memory of the mentally ill patients who died in the Esidimeni Life tragedy. The number of patients who died now stands at 143. Photo: Section27

DA Gauteng shadow health MEC Jack Bloom estimated the province paid over R2-million to Selebano and Manamela while they were both suspended with pay in February 2017.

“It is unfortunate that the disciplinary process against them was delayed by their failed challenge against the findings of the Health Ombudsman’s Esidimeni report and other stalling tactics,” said Bloom. They will face criminal charges, he anticipated. “True justice and accountability will only occur when their culpability is assessed in a court of law.”

Chairperson of Parliament’s Select Committee on Social Services, Cathy Dlamini said: “Despite the resignation, the call the committee made for accountability against those responsible for the Esidimeni tragedy remains. All necessary disciplinary and legal processes must continue and reach their natural conclusion.” She said there was a long-standing challenge in the public service of promptly resolving disciplinary cases.

Health Ombudsman Professor Malegapuru Makgoba recommended that disciplinary action be taken against Jacobus. Makhura’s spokesperson Thabo Masebe said the government prioritised disciplinary hearings for the most senior officials involved and couldn’t say whether action was taken against Jacobus. He said all those cited in the ombudsman’s report would face disciplinary action.

Another expert witness will testify at the arbitration on Friday and former MEC Qedani Mahlangu will begin her testimony on Monday, which will take most of the week. Moseneke has repeatedly asked why the department was so determined to move patients from Life Esidimeni when it was clearly not ready to do so. Mahlangu will be grilled on what role she played as the political leader of the project.

The arbitration is scheduled to finish its hearings at the end of the month with testimonies from current Gauteng Health MEC Gwen Ramokgopa and Health Minister Aaron Motsoaledi. The last witness to appear will be Premier David Makhura.

The Life Esidimeni arbitration is aimed at providing truth and closure for the relatives of those who died. Moseneke will have to advise the government on appropriate compensation to be paid. DM

Photo: Gauteng department of health deputy director of mental health Hannah Jacobus appeared at the Life Esidimeni arbitration on Thursday. Greg Nicolson