Former Gauteng health MEC Qedani Mahlangu maintained that, as a political head, she was “not an implementer and only relied on the reports provided to her by department officials” as she skirted around taking individual responsibility for the 144 mental healthcare users who died during the Marathon Project in 2016 after they were moved from Life Esidimeni facilities to those of unlicensed and unprepared NGOs.  

Advocate Willem Pienaar for the State put it to Mahlangu that she refused to grant officials more time to carry out the project despite not understanding the processes involved. However, Mahlangu insisted that “time was granted”. 

Mahlangu told Advocate Ebenezer Prophy, acting on behalf of three of the NGOs implicated, that while she accepted political responsibility for the tragedy, she did not feel she should be held individually responsible as the decision to terminate the contract with Life Esidimeni was made collectively by government officials. 

Asked about the budget of the department, which was cited as the reason for the termination of the contract, Mahlangu said the department had been overspending, including on Life Esidimeni. However, Advocate William Mokhare, acting on behalf of the Gauteng premier’s office and the provincial health department, said the mental healthcare budget had in fact been increased at the time of the Marathon Project. 

Mokhare put it to Mahlangu that based on her own evidence there was no decision by the provincial budget council to terminate the Life Esidimeni contract. Mahlangu disagreed with this statement.

Mokhare said the department was attempting to implement the National Mental Health Policy Framework by embarking on a gradual reduction of beds at Life Esidimeni in 2015. However, he said, instead of implementing the policy the department decided on its own to terminate the Life Esidimeni contract and transfer patients to NGOs. 

Mahlangu was adamant that the decision to terminate the contract came from the premier’s committee, and the decision to take the patients from Life Esidimeni was made by the department. 

She insisted that the decision to terminate the contract was not wrong, but that it was the execution that went wrong. 

Asked to detail what it was about the execution that went wrong, she said that patients were taken to NGOs “without adequate capacity and staffing, were not treated well, NGOs were not paid on time and as a result, patient care was compromised”. 

Mahlangu stressed that at all material times the then Gauteng premier David Makhura and the then finance MEC Barbara Creecy were fully aware of what was happening in the health department and of the decision to terminate the contract. 

Mahlangu seemed visibly unsettled when Advocate Adila Hassim, legal counsel for the public interest law centre SECTION27 and the families of the patients who died, started cross-examining her, and the judge told her to remain “calm” during her testimony. 

Hassim questioned Mahlangu on the contents of a letter written by Creecy to her in November 2014, asking that “the department [of health] should demonstrate the decision being taken on their budget and share the quantification of their cost containment”. 

Hassim put it to Mahlangu that this was so that the provincial budget council could see how much would be saved by the department’s proposal to terminate Life Esidimeni’s contract. 

Mahlangu disagreed, saying that she read it as being asked to add further departmental expenses that could be cut. 

Mahlangu was also questioned about a letter sent to her in October 2015 by psychiatrist Professor Lesley Robertson, copying in the South African Society of Psychiatrists. 

“We are deeply concerned,” Robertson wrote, “that community mental health services have not been sufficiently developed to accommodate these [mental healthcare users] and therefore request an appointment with the MEC for health.” 

Mahlangu said that she referred any correspondence outside of her expertise to “the relevant people who were qualified to respond to such”. 

Mahlangu told the inquest she stood by her statement of having been misled by officials, “whether intentional or not” and that she didn’t know whether the families of the patients had been consulted before the termination of the contract on 30 September 2015 as she only met the families in 2016. 

Mahlangu said she met the families to allay their fears and address concerns.  

“The contract was already terminated, so they didn’t really have a say,” replied Hassim.  

At the conclusion of Mahlangu’s testimony, Judge Mmonoa Teffo said  Makhura, Creecy and Robertson would be subpoenaed to testify as their names had continually come up at the inquest. 

The inquest is set to continue until 26 May. DM/MC