Pretoria - Qedani Mahlangu's decision to resign as health MEC 24 hours before the release of a report into the circumstances surrounding the deaths of 94 mentally ill patients in Gauteng was cowardly, the sister of one of the patients said on Wednesday."It was a cowardly act, after all the crap that she did, all the attitude that she gave us and the arrogance that she fed us. It was cowardly of her," Christine Nxumalo said.Nxumalo's sister Virginia Machpelah died at the facility of one of the five NGOs that Health Ombudsman Malegapuru Makgoba had identified as having recorded nearly 80% of the patients' deaths between March and December last year.The patients died after being transferred from the Life Esidimeni facility in Randfontein, west of Johannesburg, to numerous NGOs after the department cancelled its contract as part of cost-cutting measures.Life Esidimeni looked after about 2 000 patients and was funded by the department.Makgoba was appointed by Health Minister Aaron Motsoaledi to investigate the incident in September after it was revealed that at least 36 people had died after being transferred to new facilities between May and June.No sympathy Speaking to News24 in September, Nxumalo said she received a call on August 25 from a woman working for an NGO called Precious Angels who told her she had been caring for her sister for six weeks. She was told her sister had died a week earlier and that they had struggled to reach her family.There was a massive outcry with the family and organisations including Section27 and the SA Depression and Anxiety Group (Sadag) joining the call for Mahlangu to take responsibility and resign or be fired. They had been fighting Mahlangu's decision as far back as 2015 when the department announced that it would not renew its contract with Life Esidimeni.When affected parties and organisations tried to approach the courts in a bid to stop the department from moving the patients, the department vigorously defended the decision.The department's spokesperson Steve Mabona told News24 at the time that it was not in Sadag's or any other organisation's place to tell the department what to do.After the release of the report on Wednesday, Nxumalo said Mahlangu had never shown any sympathy to the families during their engagements."She would stand there and she would not even think twice about what she was about to say."Deaths 'unlawful'In his report Makgoba found that all 27 of the NGOs that the department had identified and moved the patients to were operating with invalid licences."Therefore all patients who died in these NGOs died in unlawful circumstances," Makgoba said.Although most of the deaths had occurred in 16 of the 27 NGOs, Makgoba said all the facilities did not have basic competence and experience, the managerial or leadership capacity, the "fitness for purpose" and were often poorly resourced, he said.During previous media briefings Mahlangu told the media that there had been nothing untoward about the NGOs and that her department had vetted them all, and that they had met the department's criteria."She said she visited these places, she didn't, she lied, and she had the balls to stand in front of the media and actually do what she did," an angry Nxumalo said on Wednesday."And now to just resign the day before, conveniently, after delaying the whole process? So she wasn't thinking about us, the families.MEC's actions 'disgusting'"She was thinking about covering herself, hence the delay. It's a cowardly act and I'm not surprised, that's the type of person she is. She needs God in her life. I don't know how she sleeps at night."Nxumalo said she wanted to pursue legal action against Mahlangu."Had she come here and at least showed her face to say that what she stood by, what she did, she believed."If you're going to take actions, at least have the guts to stand by what you do especially if you're going to be arrogant like that. But more so now that she resigned the day before, that's cowardly, it's actually quite disgusting."This was the opinion of many other family members who were at the briefing.Gauteng Premier David Makhura announced shortly after the release of the report that Mahlangu had tendered her resignation on Tuesday night as both the MEC and a member of the provincial legislature.Political accountabilityIn a statement released on Wednesday evening Mahlangu said she had noted the findings of the investigation, which was initially suggested by her to Motsoaledi, she said."For the record, the genesis of the investigation by the Health Ombud was initiated by me upon the realisation that one death too many of the patients had occurred at the NGOs. "To that end, I contacted the national minister of health requesting him to consider the appointment of the Health Ombud to look into this matter as we were very concerned about the unfortunate turn of events."Whereas the Health Ombud has not found any culpability on my part for the unfortunate loss of lives by the patients... These deaths occurred under my leadership as the MEC responsible for health in the province and I take political accountability as the final authority in the department."Makhura said he had accepted her resignation and pointed out that if she hadn't he would have still instituted Makgoba's recommendations and taken action."She fully understands that if something goes profoundly wrong in your area of responsibility and executive authority, you have to take direct accountability and not pass the buck to junior officials."Makhura named former Tshwane mayor and former deputy health minister Dr Gwen Ramokgopa as the new MEC.Constitution violatedBoth Makhura and Minister Motsoaledi expressed their anger and frustration that the department had not been forthcoming with information surrounding the deaths, and that it had taken an investigation by Makgoba to reveal the facts behind the matter.In his findings, Makgoba identified Mahlangu, head of department Dr Tiego Ephraim Selebano as well as director Dr Makgabo Manamela as the "key players" whose actions and decisions had been instrumental in the project."Their fingerprints are peppered throughout the project. The decision [to move patients] was reckless, unwise and flawed, with inadequate planning and a chaotic and 'rushed or hurried' implementation process," he said.He said there was prima facie evidence that certain officials and certain NGOs and some activities had violated the Constitution and contravened the National Health Care Act of 2002.He recommended that Makhura consider Mahlangu's suitability as health MEC and that disciplinary proceedings be instituted against Selebano and Manamela for gross misconduct in light of their conduct during the investigation, which included tampering with evidence.Makhura has tasked his director general to immediately institute Makgoba's recommendations within the prescripts of the appropriate labour laws and regulations governing the conduct of public servants."Among the public servants against whom disciplinary action will be taken is the head of department, who is the accounting officer and the senior officials identified in the report."There can be no passing of the buck," Makhura said.