The Life Esidmeni inquest resumed in the Pretoria High Court on Tuesday with the long-awaited testimony of former Gauteng Health MEC Qedani Mahlangu.

The inquest is looking into the 144 deaths that occurred when 2,000 mental healthcare patients were transferred from Life Esidimeni facilities to ill-equipped and unprepared NGO facilities in 2016.

On her first day on the witness stand, Mahlangu told the inquest the decision to transfer the patients was made by the premier’s budget committee, of which she was a member. The committee was led by the then Gauteng premier David Makhura.

“The decisions, including terminating Life Esidimeni and all the other contracts that were terminated that affected patient health care, were done with a competent team and led by people who were the authority. I was probably the only person in the department with no qualification or medical degree,” Mahlangu told the inquest.

On the issue of ill-equipped and unsuitable NGOs acquiring licences from the Gauteng Department of Health (GDoH), Mahlangu said the people she worked with would not issue licenses to NGOs for the purpose of “just wanting to comply and pleasing me. Had I known about that I would have acted decisively.”

She said she played no role in the issuing or approving of licences until she was informed by the Health Ombud, Professor Malegapuru Makgoba, that there was an issue with licensing. 

“I was informed by the HoD that [former Gauteng mental health head] Dr [Makgabo] Manamela has been issuing licences to NGOs for the longest of times so I had no reason to doubt that.”

Read more in Daily Maverick: ‘I’m the scapegoat’, says Gauteng health department’s Makgabo Manamela

Mahlangu stressed that she was not a medical doctor and had relied heavily on the expertise of the medically qualified staff in her department.

She conceded that the deinstitutionalisation of mental health patients could have been handled better. However, she said, the “Gauteng provincial Department of Health had started deinstitutionalisation long before I came.”

She said she had told the Gauteng legislature that not all patients would be going to hospitals and “the balance of patients” would be taken to NGOs. 

Mahlangu said that when they were informed that it was not feasible to conclude the cancellation of the contract with Life Esidimeni by 30 March 2016, the department gave an extension until 30 June 2016.

Once all the patients had been placed in NGOs, Manamela presented a report to the GDoH to highlight areas that still needed to be attended to.

She said she had encouraged the families of the patients to form a family committee.

“I further encouraged them to give me a call in case the officials were not assisting them or misdirecting them. I further asked them to go to the NGOs and visit the NGOs with the officials, and where they were not pleased with the NGOs I further encouraged them to call me and report [if] their views were not listened to.”

Mahlangu apologised for the deaths of the patients, which she described as “regrettable” and told the inquest that she had been greatly affected by the tragedy and was undergoing therapy to help her deal with it.

The inquest continues. DM/MC