Former Gauteng Department of Health deputy director-general Dr Richard Lebethe was asked whether he knew if the minister, MEC or premier were aware of the project to transfer patients to NGOs from Life Esidimeni. He responded that he could not confirm whether the minister and premier knew but that former MEC at the time, Qedani Mahlangu, knew.

Lebethe told the inquest that patients with comorbidities needed to be examined in different ways, which took into account their mental state and state of comorbidities. 

Lebethe told the inquest that it was not possible for GDoH officials to foresee that patients would get infections that would ultimately result in their deaths after being transferred from Life esidimeni and that the deaths of 144 patients could not be attributed to the marathon project. 

“We are looking at it retrospectively now…we do have the benefit of the doubt but prospectively it would have its own challenges so, you can’t be absolute.”

Lebethe said there were no “absolutes” in medical conditions, and clinicians have no way of knowing for certain what could happen to patients as there may be variations.  

“Infections don’t depend on movement or lack of it… Attributing the cause of deaths to the moves plainly like that becomes difficult. Especially if it happens a long time after the movements.”

Asked if he agreed with the GDoH’s termination of the Life Esidimeni contract, Lebethe answered that he could not say for certain because he was not actively involved in the project.

Lebethe was also asked whether an agreement between GDoH and Life Esidimeni, which stated that patients were not to be moved until the South African Depression and Anxiety’s Group had seen the project plan and assessed on whether the move would be beneficial to mental healthcare users, was ever adhered to. 

He replied that: “I think it was at some stage, but then I don’t remember how it got to basically turn around in terms of them maybe not getting the appropriate information.”

Lebethe testified that it was with “worry, concern and urgency” that he was told by Mahlangu of eight deaths that had occurred. When asked who gave the order for the post mortem of the bodies, Lebethe said  it was standard procedure for patients who had died at institutions.

He also said that deaths had to first be reported to the police, because any “physical body” that was to go into forensic pathology needed a case docket which was obtained from the police. DM/MC