Statement issued by Gauteng Department of Health, 21 October 2015:

Gauteng Health terminates Life Healthcare Esidimeni contract

The Gauteng MEC for Health, Ms Qedani Mahlangu, announced on Tuesday, that the Department had given notice to terminate its contract with Life Healthcare Esidimeni Hospital. The facility provides inpatient care, treatment and rehabilitation for people with chronic psychiatric disorders, and severe intellectual disability.

The contract termination is in line with the Mental Health Care Act no 17 of 2002, which encourages mental health care practitioners to treat mental health care users in the least restrictive environment, as reflected in Chapter two subsection 6(8)(1)(2): Persons providing care treatment and rehabilitation service must provide such services in a manner that facilitates community care of mental health care users, human dignity and privacy of every mental health care user must be respected, every mental health care user to develop to full potential and be integrated to the community.  

“Consequently, as a Department, we want to reduce psychiatric patients at facilities by discharging all those who are responding well to treatment and integrate them back to communities and afford them treatment at their respective homes”, said MEC Mahlangu.

“Patients that require further management will be referred to our hospitals which have psychiatric wards and this will help as patients will be treated closer to home.  We will also continue to work with NGOs in the mental health environment to assist us manage these patients accordingly. In preparation for the said termination, the Department will be referring less patients to the Life healthcare Esidimeni Hospital”, added the MEC.

“During 2014/2015 financial year the Department spent about R323 712 000.00 on the said hospital for treatment of around 2378 patients. It is important to note that the Department cannot afford this, the budget allocation which was previously utilised on the said facility will be reprioritised accordingly. This process will also assist our efforts to employ more employees at our psychiatric wards”, concluded MEC Mahlangu.

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Extract from speech by Jack Bloom MPL DA Gauteng Shadow Health MEC, in debate on the Gauteng Health Annual Report on 30 November 2015

The department has made a colossal mistake in cancelling the contract with Life Healthcare Esidimeni for about 2000 psychiatric patients.

The Honourable MEC claims that there are sufficient spaces for these patients within existing hospitals and with NGOs.

I have spoken with many NGOs, and they deny that they have enough spaces, nor do they have the necessary specialist staff.

I also don’t see how the necessary renovation and extra staff in existing state facilities will be available by the end of March next year when all these patients are discharged.

It’s a looming disaster. Does the Honourable MEC really want hundreds of people on the streets or with families who cannot care for them?

Please, please reconsider.

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Statement by Jack Bloom, 21 January 2016:

LITTLE PROGRESS IN FINDING HOMES FOR 1900 PSYCHIATRIC PATIENTS

The Gauteng Health Department has made little progress in finding new homes for about 1900 psychiatric patients who will be discharged at the end of March because of the cancellation of its contract with Life HealthcareEsidimeni.

Yesterday I visited the Waverley Care Centre in Germiston run by Esidimeni. They have 640 patients, of which only 98 are well enough to be discharged. The difficulty with some of these patients, however, is that they do not have identity documents, or do not have family to go to, or are foreigners.

There are another 1300 patients housed by Esidimeni at the Randwest Care Centre in Randfontein. 

Esidimeni used to look after more than 2000 patients with chronic psychiatric disorders and severe intellectual disorder, but has only managed to reduce this to about 1900 patients by discharging patients to suitable NGOs.

An urgent court interdict was sought late last year against the department by three mental health NGOs on behalf of patients' relatives, and the department agreed not to discharge any patients until the end of January and to consult on a plan for alternative placement of the patients.

The department claimed that it would be able to look after all the patients by the end of March by placing them in existing government buildings and with NGOs.

But no progress has been made with renovations to the identified facilities, which include the old Germiston hospital, empty wards at Weskoppies and Sterkfontein, the Dan Pienaar creche in Parktown and the old nurses residence at the Transvaal Memorial Institute opposite Constitution Hill. The latter two buildings are derelict.

There is no way that the facilities will be ready to take patients by the end of March, and NGOs do not have the capacity to take large numbers either.

Meanwhile, the relatives of patients are increasingly anxious as the deadline approaches.

The department should extend the contract with Esidimeni for at least another 6 months, otherwise there will be a human disaster if the patients are forced onto the streets.

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Statement by Jack Bloom, 16 February 2016:

DA SUPPORTS RELATIVES OF PSYCHIATRIC PATIENTS

The Democratic Alliance supports the protest march today in central Johannesburg by relatives of 1900 psychiatric patients who will be discharged at the end of March because of the cancellation of the contract between the Gauteng Health Department and Life Healthcare Esidimeni.

They have every right to be concerned as the Department has made little progress in finding alternative places for the discharged patients.

The promised renovations have not been made to the identified facilities, which include the old Germiston hospital, empty wards at Weskoppies and Sterkfontein, the Dan Pienaar creche in Parktown and the old nurses residence at the Transvaal Memorial Institute opposite Constitution Hill. The latter two buildings are derelict.

Existing NGOs do not have the capacity to take large numbers either.

My view is that the department should extend the contract with Esidimeni for at least another 6 months, otherwise there will be a human disaster if the patients are forced onto the streets.

I will raise this issue at the Health Committee of the Gauteng Legislature.

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Statement by Jack Bloom, 18 February 2016:

DA WELCOMES EXTENSION OF CONTRACT FOR PSYCHIATRIC PATIENTS

I welcome the announcement by the Gauteng Health Department that they have extended their contract for psychiatric patients looked after by Life Healthcare Esidimeni by three months.

About 1900 psychiatric patients would have been discharged at the end of March, but the contract has now been extended until the end of June.

I hope that this is enough time to make alternative arrangements for these very vulnerable patients who need specialized care as their families cannot look after them.

If three months is not enough, then the contract should be extended further.

***

Statement by Jack Bloom, 15 March 2016:

1835 PSYCHIATRIC PATIENTS STILL TO FIND ALTERNATIVE HOMES IN GAUTENG

There are 1835 psychiatric patients still in the care of Life Healthcare Esidimeni who will be placed in alternative homes before the end of June this year.

This was disclosed today by Gauteng Health MEC Qedani Mahlangu in an oral reply to my questions today in the Gauteng Legislature.

According to Mahlangu, existing health facilities are all "almost ready" to take the patients and NGOs are hiring staff and being given licenses to look after them as well.

She said that patients were being transferred on an ongoing basis to the new facilities and to NGOs and there would be no patients with Life Healthcare by the end of June when the three-month extension to their contract expires.

She defended the recent transfer of 54 patients, including the very elderly, to the Takalani Centre in Soweto for the intellectually disabled, which was approved today by a court after being challenged by mental health NGOs.

I am not convinced that everything is going as smoothly as the MEC claims.

There are many anxious families who are unable to look after relatives who are shortly going to be discharged from Life Healthcare, and I hope that suitable facilities can indeed be found for them.

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Statement by Gauteng Department of Health, 15 March 2016:

Health within its right to discharge mental patients: Court

The Gauteng South High Court has dismissed the urgent interdict brought by SADAG (South African Depression and Anxiety Group) which sought to prevent the Gauteng Department of Health from discharging 54 patients and placing them at an NGO, Takalani Home from Life Esidimeni mental institution.

The Court agreed with the Department that it has not reneged on an agreement reached with SADAG and other organisations in December 2015. And as such the Department should continue with its plans to discharge and place those who still need medical care to different facilities. 

And contrary to SADAG allegations, the Department has kept everyone concerned informed  about plans to place patients at various NGOs as part of winding up services with Life Esidimeni, as the contract with the institution will be coming to an end on June 30, 2016.

As stated previously that the doctors took a decision based on clinical reasons that patients be discharged. The planned placement of patient will be conducted in phases.  A concern raised by SADAG that Takalani Home caters for children was not accepted by the Court, since the Department made it clear that children will be separated from adults and placed accordingly.

Gauteng MEC for Health, Ms Qedani Mahlangu, welcomed the Court findings and assured that the Department will continue to work with various stakeholders.  “We welcome the court findings. It should be noted that, we will continue to work with all stakeholders to make sure that no patient will be neglected or thrown on the streets as result of this contract termination,” said MEC Mahlangu.

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Statement by Jack Bloom, 17 March 2016:

TRANSFERS OF GAUTENG PSYCHIATRIC PATIENTS BADLY HANDLED

The transfer of hundreds of mentally ill patients from Life Healthcare Esidimeni to other health facilities is not going well as many relatives are not informed where they are moving and their medication and clothing is sometimes left behind.

Following the cancellation of the Gauteng Health Department's contract with Life Healthcare about 1900 psychiatric patients have to be discharged by the end of June.

The SA Depression and Anxiety Group (SADAG) has been inundated by calls from anxious families who don't know where their mentally ill relatives have been taken.

I am concerned by the disorderly transfer of vulnerable patients to a variety of NGOs and provincial health facilities that may not be able to provide adequate care for them.

The Gauteng Health Department has been rushing this transfer for budgetary reasons, but needs to ensure that there are proper arrangements to inform relatives and maintain the health and dignity of the psychiatric patients.

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Statement by Jack Bloom, 9 June 2016:

DA supports march by relatives of Gauteng mental health patients

I will be joining the protest march today by relatives of psychiatric patients who are being discharged by Life HealthcareEsidimeni hospitals after the Gauteng Health Department terminated its contract with them.

The Esidimeni Committee of Families says that many patients have been transferred to unsuitable facilities, often without informing relatives where they are or ensuring that they have their clothes and belongings with them.

About 2000 severely mentally ill or intellectually disabled patients were looked after by Esidimeni, but transfers have been taking place to other facilities as the Department's contract expires at the end of June.

I am concerned that alternative facilities are not ready to receive these very vulnerable patients who need specialized care.

The transfers have also not been done with sensitivity and care for the dignity of the patients.

I hope that the Department responds positively to the protest march to their head office in Johannesburg this morning.

***

Statement by Jack Bloom, 28 June 2016:

WHAT HAS HAPPENED TO MENTALLY ILL PATIENTS IN GAUTENG?

Questions remain about the fate of hundreds of mentally ill patients discharged from the Life Esidimeni Randfontein Care Centre which has now become a drug and alcohol rehabilitation center.

There was an unseemly haste to send away the last 300 mentally ill patients last Friday before the official opening of the drug rehabilitation centre on Sunday in the same building.

This centre is being run in partnership with the Gauteng Department of Social Development which is welcome news, but many relatives of the departed psychiatric patients are unhappy about the new facilities that they have been placed in.

Some have been placed at Weskoppies and Sterkfontein hospitals, and others at NGOs that do not appear to have the staff or expertise to look after them.

Family members of mentally ill patients protested outside the Gauteng Health Department Head Office in early June     because they were unhappy about the transfers from the Randfontein centre.

It remains to be seen whether all the 2000 patients who used to be accommodated by Esidimeni are properly looked after.

The Gauteng Health Department needs to monitor the facilities where long-term psychiatric patients have been placed and make improvements where necessary.

***

Statement by Gauteng Department of Health, 7 July 2016:

Gauteng Health satisfied with patient transfer from Life Esidimeni

The Gauteng Department of Health wishes to inform the public that the process to move patients from Life Esidimeni to NGOs and psychiatric hospitals is now complete.

According to information at our disposal, all NGOs are capable of taking care of patients. MEC Mahlangu visited two NGOs and was satisfied with the conditions as well as the level of care and she plans to visit other NGOs in future.

Gauteng Health MEC, Ms Qedani Mahlangu said: “We wish to assure the public that all minor issues of concern are currently being attended to and should be resolved in due course. We call upon family members who might have concerns about patient transfer to interact directly with the Department.”

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Statement by Jack Bloom, 17 August 2016:

What happened to 400 psychiatric patients in Gauteng?

17 August 2016

Mystery surrounds the whereabouts of about 400 chronically ill psychiatric patients who were discharged earlier this year from Life Healthcare Esidimeni after the Gauteng Health Department cancelled its contract with them.

According to a written reply by Gauteng Health MEC Qedani Mahlangu to my questions in the Gauteng Legislature, 1362 psychiatric patients were relocated from Esidimeni to three hospitals and 25 NGOs. A further 91 patients were discharged to the care of their families.

But last year, in another written reply to my questions, Mahlangu said that 1671 patients at Esidimeni needed long term care, and NGOs would also accommodate 113 patients that need medium term care but are categorized as high level functioning patients.

I am concerned that 1784 patients were supposed to be placed in hospitals and NGOs, but this has only happened for 1362 patients.

What happened to about 400 mentally ill patients who should have been placed in institutions?

The Department originally said that it would house 1193 patients at the Weskoppies, Sterkfontein, Tshwane District and Cullinan Care hospitals, as well as refurbished parts of the Transvaal Memorial Institution (TMI), Pinnar and Old Germiston Hospital. NGOs were supposed to house 591 patients.

According to Mahlangu, however, only 360 patients have been housed at Weskoppies, Sterkfontein and Cullinan, and none whatsoever at Tshwane District, TMI, Pinnar and Old Germiston Hospital. A total of 1002 patients are now in 25 NGOs, ranging from 197 patients at Tshepong to 1 patient at Hephzibhar.

This shows extremely poor planning, and there are many complaints from relatives about the unsuitability of the NGOs and lack of care for patients who sometimes don't get their medicine.

It is very distressing that vulnerable people have been treated so badly.

The Gauteng Health Department should clear up the mystery of the missing patients and tighten supervision of the NGOs that currently look after the long-term mentally ill. If a NGO is not able to offer quality care, the patients should be transferred elsewhere.

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Statement issued by Gauteng Department of Health, 17 Aug 2016

No missing patients from Life Esidimeni

The Gauteng Department of Health wishes to put it on record that it has not abdicated its responsibility towards patients that were moved from Life Esidimeni when the contract was terminated in June 2016.

All the NGOs are funded by the government for general upkeep of the patients and medical care which includes psychiatry and psychological treatment, procurement of medicine and other consumables.

It should be noted that there are no missing patients from the Life Esidimeni, however, those that cannot be accounted for at NGOs and Gauteng psychiatric hospitals were taken home by their families.

The decision to terminate Life Esidimeni contract was not taken lightly. Prior to moving patients the Department together with patient’s relatives visited the NGOs to certify that they were suitable for upkeep of mental patients.

Most of these facilities proved capable of providing inpatient care, treatment and rehabilitation for people with chronic psychiatric disorders, and severe intellectual disability. We continue to visit all facilities and NGOs to monitor the process.

“The budget allocation which was spent on the institution is now being reprioritised and will ensure that we employ more employees at our psychiatric wards in our hospitals. During 2014/15 financial year the Department spent about R323 million on Life Esidimeni. It is important to note that the Department cannot afford this, which was likely to escalate yearly,” said MEC Qedani Mahlangu.

“Furthermore, the contract termination is in line with the Mental Health Care Act no 17 of 2002, which encourages mental health care practitioners to treat mental health care users in the least restrictive environment, as reflected in Chapter two subsection 6(8)(1)(2): Persons providing care treatment and rehabilitation service must provide such services in a manner that facilitates community care of mental health care users, human dignity and privacy of every mental health care user must be respected, every mental health care user to develop to full potential and be integrated to the community,” reiterated  Mahlangu.

The department also absorbed employees of Life Esidimeni in order to ensure that they do not lose their jobs while benefiting from their skills in taking care of mental care users.

The department continues to engage families who have decided to take their relatives home while they cannot take care of them, with aim to encourage a release of those patients in our care. We will also make sure that all those that stay far from facilities are assisted with transport when they wish to visit their relatives in NGOs or at our psychiatric hospitals.

We wish to express our sincere apology for any inconvenience this process might have caused to families and encourage them to interact with the department directly for immediate intervention.

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Statement by Jack Bloom, 2 September 2016:

CONCERNS REMAIN ABOUT BOTCHED PSYCHIATRIC TRANSFERS IN GAUTENG

Gauteng Health MEC Qedani Mahlangu had a press conference yesterday to allay concerns about the transfer of hundreds of psychiatric patients to NGOs, but concerns remain about the quality of care that they receive.

Mahlangu dodged the toughest questions by barring relatives of patients, Section 27 lawyers and the SA Depression and Anxiety Group (SADAG) from the conference. If she has nothing to hide, why were they not allowed to ask questions?

Last year, Mahlangu said that 591 long-term psychiatric patients formerly cared for by Life Healthcare Esidimeniwould be placed in NGOs, and others in a variety of state institutions and renovated facilities including the old Germiston Hospital, Pinnar and Transvaal Memorial Institute.

None of the promised renovations to the named facilities occurred, and 1002 patients were placed with 25 NGOs, almost double the number originally announced.

Complaints have poured in about poor conditions at some of these NGOs, including poor medical attention and living conditions, and lack of food.

Mahlangu has confirmed that some NGOs were not suitable, like Bokang Home Care Centre where 23 patients were removed, but problems remain at other NGOs.

It is clear that the transfer of patients from Life Healthcare to NGOs was botched in many instances.

MEC Mahlangu should not arrogantly dismiss the concerns raised by relatives, SADAG and Section 27. Problems remain and need to be addressed urgently for many vulnerable patients who are being treated badly.

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Statement by Jack Bloom following question put to MEC in Gauteng Legislature, 13 September 2016:

36 TRANSFERRED PSYCHIATRIC PATIENTS HAVE DIED IN GAUTENG

Thirty six psychiatric patients that were transferred from Life Healthcare Esidimeni earlier this year have died while in the care of the NGOs in which they were placed by the Gauteng Health Department.

This was disclosed today by Gauteng Health MEC in an oral reply to my questions in the Legislature.

The psychiatric patients were moved into 122 NGOs after the department cancelled its long-running contract with Life Healthcare which looked after about 2000 patients.

I am horrified that so many patients have died from undisclosed causes after being transferred to NGOs, many of which relatives have said are unsuitable.

I am aware that 8 patients died at the Previous Angels NGO and some others died at Takalani and at the Cullinan Centre. 

Mahlangu said that the patients were transferred without clinical files that detailed their medical history, and doctors were sent to the NGOs to examine the medical needs of the patients.

She said that investigation was continuing into the cause of the deaths.

I challenged the MEC to apologize for the poor manner in which the transfers to NGOs were done, and she said that the department had apologized where mistakes had been made.

There needs to be accountability for the deaths of so many patients. The department should ascertain the cause of death in all cases and take stern action where there is proven negligence.

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And the social media response after Jack Bloom laid culpable homicide charges against now former MEC Qedani Mahlangu, 3 February 2017: