- Life Esidimeni warned Gauteng health officials that moving patients to NGOs might be fatal to them.
- Two children died in 2007 when the department moved them from a Life Healthcare facility to an NGO.
- The health department moved patients in a cost-cutting measure.
When the Gauteng health department wanted to move patients from Life Esidimeni to NGOs, they were warned that this might be similar to a 2007 move that left two children dead.
Dr Morgan Mkhatshwa, the former MD of Life Esidimeni, said the hospital group warned the department on numerous occasions that moving mental health patients to NGOs might be a death sentence.
Mkhatshwa is testifying at the Life Esidimeni inquest at the Pretoria High Court, which will determine if anyone can be held criminally liable for the deaths of 144 mental healthcare patients.
The Gauteng health department moved patients from Life Esidimeni facilities to ill-equipped NGOs where they died of hunger, neglect and dehydration.
When the department informed the Life Healthcare group that they wanted to terminate the contract with them to cut costs, the group was worried that the deaths that happened in 2007 would happen again, Mkhatshwa said.
In 2007, the health department moved 15 children from the Life Health Baneng Care Centre to an NGO on a trial basis. Two of the children died, and the others who were returned to Life Esidimeni, were severely dehydrated and malnourished.
Mkhatshwa said they warned the department that NGOs would not have sufficient resources to care for patients. For instance, at Life Esidimeni facilities, patients had access to a medical doctor daily.
"Our costs were already as low as possible. We were able to offer that service because of the scale of the Life Health group. We doubted that any NGO could offer the same quality at that cost. These mental health [patients] also had comorbidities. They needed someone with a clinical eye to care for them."
He said the broader Life Esidimeni group would subsidise the mental healthcare side when the health department didn't pay their costs.
Mkhatshwa said moving patients was done haphazardly.
"The timeframes put pressure on the staff. It was haphazard because we didn't know where the [patients] were going to. We were the point of call between [patients] and families. When families came to us and asked where the users were, and we didn't know, it was haphazard. Did we have control over what happened in transit from Life Esidimeni and the NGO? Absolutely zero."