Speaking at the Life Esidimeni hearings on Tuesday, Creecy exploded the provincial health department’s defence by denying that enormous cost-cutting pressure had been placed on them by Treasury.

The three most senior Gauteng Department of Health (GDoH) officials who have testified at the arbitration hearings taking place in Johannesburg since October last year all said that the move of about 1700 mental health patients occurred as a result of pressure from both national and provincial Treasury to save money in a cash-strapped department.

Former Health MEC Qedani Mahlangu, former head of department Dr Barney Selebano and former director of mental health Dr Makgabo Manamela all claimed to have been heavily pressured to cuts and have all since resigned from their positions.

The termination of the Life Esidimeni contract and subsequent move of patients to ill-equipped and illegally licenced non-governmental organisations (NGOs) left 144 people dead. It was revealed on Monday that more than 60 patients are still unaccounted for, raising concerns that the death toll may be even higher than reported.

“Treasury never demanded that any department cut core services,” Creecy said to applause from the audience, predominantly composed of concerned family members.

The provision of mental health is seen as a core service, and she said that her department had requested cost-cutting measures in areas such as travel, public events, catering, communication and the hiring of consultants.

Shortage of beds

Furthermore, when the project was first proposed to the Premier’s Budget Council by the health department in November 2014, NGOs were not included in any way as part of the plan.

Creecy said that the GDoH stated it intended to move patients from Life Esidimeni facilities to other state facilities but may and that there would be problems only if there was a shortage of available beds.

“And what we said was that if you want to transfer patients … if you think you can [care for patients] more cost-effectively in-house that’s fine, but the department should ensure it does not affect the quality of those services,” Creecy said.

While the project was intended to save the department money and reduce the amount spent on caring for institutionalised mental healthcare users, Creecy said that the money spent on mental health services had increased year on year, including after the project came to a fatal end in 2017.

Section27 advocate Adila Hassim, representing the majority of affected families, said previous testimony suggested that moving patients to provincial hospitals “would cost [the GDoH] up to six times as much as they were paying Life Esidimeni”.

Creecy said that the health department was even given an opportunity to identify “priority areas if additional money [became] available” for Treasury to assist with needed additional budget allocations, but that mental health was never mentioned by the GDoH.

The health department identified things like electronic patient records, archiving and equipment “but nowhere does it say we are not able to provide services for psychiatric patients”, she said. “And we specifically asked them ‘Where do you need additional money?’ and we did indeed give them additional money.” – Health-e News.