Day two of the inquest saw former Life Esidimeni managing director Basuku Mkhatshwa back in the witness hot seat, where he said that the Gauteng Department of Health (GDoH) acted unilaterally in its decision to move patients and that he had made it clear that he did not support the decision.

Mkhatshwa said Life Esidimeni did not receive important information for the transfer of patients, such as “where were they being transferred to, when they were going to leave, what time they were going to leave, how they were going to leave”. He also said that the number of mental health care users to be discharged would change on a daily basis which caused a lot of confusion.

Mkhatshwa said, “The information that I had was that an instruction had come up from the MEC to instruct Esidimeni to reduce the number of beds”.

Advocate Russel Sibara acting on behalf of former Gauteng Health Director Dr Makgabo Manamela, attempted to distance Manamela from the decision to transfer mental health care users from Life Esidimeni which resulted in 144 deaths. Sibara said that Manamela had no influence in the decision to move patients as she was not involved in the decision-making process to terminate the contract between GDoH and Life Esidimeni.

Manamela’s legal counsel told the inquest that she was forced to implement the transfer of mental health care users, “whether she likes it or not”, arguing that the decision to move patients was on the instruction of former Gauteng Health MEC Qedani Mahlangu which she had told Mkhatshwa. Sibara said Manamela’s “hands were tied” and that she would have been fired for not following the health MEC’s instruction.

Confirming this, Mkhatshwa said the situation lead to him having “an outburst” in one of the meetings concerning the transfer, where he had asked “are we clinicians or what? Are we just going to implement instructions without question[ing] the instructions and being able to do whatever we need to do for the best interests of the mental health care users?”

Sibara told the inquest that Manamela maintained that the NGOs to which the mental health care users had been sent were vetted by the GDoH and had met the necessary criteria.

He also went on to say that in one of the quarterly meetings Manamela had raised concerns that one of the Life Esidimeni facilities had mental health care users who required hospitalisation because they were “frail”. Mkhatshwa denied knowledge of this saying that he never heard of such a concern being raised.

Mkhatshwa also denied knowing of patients who committed suicide or were malnourished while he was working at the Life Esidimeni facilities, saying that “Every death at Life Esidimeni was investigated and reported to the Department of Health.”

He also denied reported shortages of clothing and blankets for the mental health care users.

Advocate Amanda Gxogxa representing state witness Rochelle Gordon put it to Mkhatshwa that most mental health care users discharged in May 2016 were “very weak and sickly” and were not supposed to have been transferred to an NGO. In response, Mkhatshwa said that is why he had told the GDoH to ensure that there were medical professionals in place to receive and manage the transfer of the mental health care users. 

The inquest is set to continue until 17 September. DM/MC