Dear friends,
For those of you who didn’t hear or read it yesterday, below is an extract from the opening of the Gauteng Premier’s State of the Province address:
Please join me in acknowledging the presence of members of the Family Committee representing the bereaved families of the Life Esidimeni tragedy in which more than a hundred mental health patients lost their lives.
Madame Speaker, we have been working very closely with the Family Committee as we implement the remedial action outlined by the Health Ombud, Professor Malegapuru Makgoba, in his report released on 1 February 2017.
On Saturday 18th February, we held a Healing Ceremony at the Freedom Park, at the request of the bereaved and affected families. At the Healing Ceremony families made an impassioned plea that as we mourn the tragic death of the mental health patients and take decisive corrective action, politicians and political parties must be advised not to use this tragedy as a political football because this prolongs their pain and anguish. I hereby appeal to this House to honour the wishes of the families. This is my humble appeal.
As we implement the recommendations of the Health Ombud Report, every step we take will be guided by the wishes of the families and the advice of the panel of sixty experts appointed by the Minister of Health, Dr Aaron Motsoaledi.
The pace at which we move in implementing all the recommendations of the Health Ombud is determined strictly by the wishes of the families and the advice and opinions of experts. We are also collaborating with civil society in this process.
As the Premier of this province, I have publicly stated my deep regret and profuse apology for the tragic death of so many of our vulnerable citizens who were under the care of the Gauteng Department of Health.
I want to reiterate the commitment I made to the families on Saturday: I will spend the remainder of my term over the next two years, to ensure that there is restorative justice and healing for the families and take every executive action possible to restore confidence in our public health system.
I would like to state categorically that the decision to transfer Life Esidimeni mental health patients to NGOs was not made in consultation with the Provincial Executive Council. The Executive Council and I would have never approved a plan to outsource mental health, a primary responsibility of the state to care for the vulnerable in society, to NGOs. What is even worse is the fact that such NGOs didn’t meet appropriate standards and legal prescripts.
The Provincial Department of Health had repeatedly reported that, as a result of the new hospitals and community health centres, they had enough beds in public health facilities that could accommodate public patients from private health facilities such as Selby Hospital and Life Esidimeni centres.
As the Provincial Executive Council, we do not interfere in the appointment or retention of service providers by various departments, in strict observance of the laws of our land. We dare not be found on the wrong side of the law.
I have always emphasised to all MECs and HODs reviewing contracts with any service provider must never compromise service delivery, especially the most vulnerable groups which depend entirely on the state for the well-being. Cost considerations can never override the imperative of the quality of care.
It is common cause that the ill-fated transfer of patients to the NGOs compromised the wellbeing of mental health patients. At the very least, the Department should have placed all patients in public health facilities or retained the services of private facilities in case there was no sufficient space in the public sector. As the Head of Government, I am deeply aggrieved by the extent to which those responsible for this tragic and ill-fated transfer of patients to unlawfully operating NGOs, have tried to hide the facts from me, the Minister of Health and the Health Ombud.
Together with the Minister of Health and the newly-appointed health MEC, Dr Gwen Ramokgopa, we are taking swift action to implement all the recommendations of the Health Ombud, the most urgent which is to relocate the mental health patients to appropriate facilities. We will provide regular updates to the Legislature, the Health Ombud and the public on the progress.
We are also working very closely with the families to deal with all the issues in the Health Ombud Report. On Saturday, we hosted a Healing Ceremony for the affected families and this was a heart-rending moment for all of us. We will erect Memorial Stones at the Freedom Park in honour of all those who passed on.
Learning from this tragic death of mental health patients, I have decided to institute a wide-ranging inspection and condition assessment of all centres that care for the most vulnerable – the elderly, people with disabilities and children – whether they are operated by the public, private or NGO sectors.
It is our responsibility as the state to care for the weak. Every institution that provides services to the most vulnerable must meet appropriate standards. We cannot wait for another tragedy before we take wide-ranging action. The Life Esidimeni tragedy must spur us into action over the next two years to restore the dignity and human rights of mental health patients and all vulnerable groups in our communities. I am determined to lead this mission over the next two years of my term of office as the Premier of this province. I will appoint the Premier’s Mental Health Advisory Panel to assist in this mission.
Clearly, this is a moment we should seize in the manner suggested by Crick and others. SECTION27 is ready to give any assistance we can to your endeavours and under your leadership as experts in this field of health care and human right
Mark Haywood
To download the PDF of this newsletter click here
First published on MyNews24 written byMichael Simpson, Cybershrink on Health24 03 February 2017,
Cybershrink considers the outrageous and fatal neglect of the needy
Dr Malegapuru Makgoba, the Health Ombudsman, has done the nation a service in exposing some of the horrific story of the many vulnerable people allowed to die from dreadful neglect, due to shocking negligence and sheer carelessness of health officials. Penny-pinching in the name of saving money, while still enjoying their own generous salaries and perks, they allowed more than 90 helpless individuals to die terrible deaths by being handed over to groups unable or unwilling to provide even very basic care.
At least 94 humans, dependent on the help of others, died of neglect after transfer from institutions capable of providing such aid, to others that were not properly registered, not competently run, and without any due supervision. We’re not talking of a lack of highly sophisticated treatment : but a lack of food, water, warmth and safe shelter. Neglect on a scale most of us find hard to imagine. These people died needlessly, in most unpleasant and easily preventable ways. Dying of dehydration, cold, or hunger, is very unpleasant indeed. And dying of pneumonia or other easily treatable conditions is careless in the extreme, and implies a sense of euthanasia, of allowing people to slide away from neglected illness, because someone decides their lives are not worth preserving.
If the same neglect had been imposed on dogs, the SPCA would have been able to prosecute the perpetrators ; but with humans, our reactions are far less efficient.
It’s essential that bureaucrats must not be allowed impunity, and everyone involved in the decisions to move people to such inadequate facilities, in the failure to monitor their well-being, and in the failure to act promptly to rescue them, should be rapidly investigated and prosecuted. The well-known and over-used South African tactic, of allowing people to simply resign and then escape all consequences for their actions and inactions, must no longer be tolerated. Too often, falsely, in the name of “providing the survivors and families with closure” the system instead provides perpetrators with closure and immunity. What is being closed, and for who’s benefit ?
Apparently, the disastrous moves were not just stingy, but made in the name of “deinstitutionalization”, a dangerous weasel word. It makes sense, where possible, to try hard to avoid making people dependent on the care of comprehensive institutions, such that their ability to care for themselves, or to retain as much care in the community as practical, is impaired. But to suddenly dump people who are totally dependent on the care of others, on people eager to be paid for taking them on, but reluctant or unable to actually provide even minimal care, is plain wicked. Don’t call it “community care” where the community patently does not care.
Don’t rely on any NGO just because of what they claim they can do : assess carefully their track record of what they actually DO, especially what they do when nobody’s looking. They should never ever be accredited or licensed for mere convenience, and without evidence that they reliably meet proper criteria.
It is alleged by some that the transfers did not include what was the absolute duty of all doctors, nurses and administrators previously involved in their care, to ensure that all patient records, and relevant information about their needs, was transferred with them. Indeed, where very sick or fragile patients are concerned, it would be appropriate for caregivers to make contact with those who took over from them, to check that the people are being properly cared for.
Not providing families with information, before and after the deaths, adds a fresh layer of needless cruelty.
But to make it worse still, these deaths were foreseen ; there were protests and warnings, from professionals and experts, families and advocacy groups. All this was stonily ignore by apparently relentless and arrogant officials, certain that they knew best and should not be challenged. Such petty tyrants should never be allowed to believe they are impregnable and or be able to ignore challenges and protests.
If the officials responsible for this debacle knew so little about what they were doing, or about the cruel results of their commands : what have we been paying them for ?
Does such gross and callous negligence amount to culpable homicide, or some other serious crime ? Such questions need to be asked and answered, and soon. If such suffering were imposed on duly convicted prisoners, there’d be talk of torture. These were not civil servants : they were never civil, and not sufficiently servants of the people.
Maybe these could be some of the first cases Gerrie Nel could tackle in his new post ?
3 FEBRUARY 2017 | GENEVA – New guidance from WHO, launched ahead of World Cancer Day (4 February), aims to improve the chances of survival for people living with cancer by ensuring that health services can focus on diagnosing and treating the disease earlier.
New WHO figures released this week indicates that each year 8.8 million people die from cancer, mostly in low- and middle-income countries. One problem is that many cancer cases are diagnosed too late. Even in countries with optimal health systems and services, many cancer cases are diagnosed at an advanced stage, when they are harder to treat successfully.
“Diagnosing cancer in late stages, and the inability to provide treatment, condemns many people to unnecessary suffering and early death,” says Dr Etienne Krug, Director of WHO’s Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention.
“By taking the steps to implement WHO’s new guidance, healthcare planners can improve early diagnosis of cancer and ensure prompt treatment, especially for breast, cervical, and colorectal cancers. This will result in more people surviving cancer. It will also be less expensive to treat and cure cancer patients.”
All countries can take steps to improve early diagnosis of cancer, according to WHO’s new Guide to cancer early diagnosis.
The three steps to early diagnosis are:
- Improve public awareness of different cancer symptoms and encourage people to seek care when these arise.
- Invest in strengthening and equipping health services and training health workers so they can conduct accurate and timely diagnostics.
- Ensure people living with cancer can access safe and effective treatment, including pain relief, without incurring prohibitive personal or financial hardship.
Challenges are clearly greater in low- and middle-income countries, which have lower abilities to provide access to effective diagnostic services, including imaging, laboratory tests, and pathology – all key to helping detect cancers and plan treatment. Countries also currently have different capacities to refer cancer patients to the appropriate level of care.
WHO encourages these countries to prioritize basic, high-impact and low-cost cancer diagnosis and treatment services. The Organization also recommends reducing the need for people to pay for care out of their own pockets, which prevents many from seeking help in the first place.
Detecting cancer early also greatly reduces cancer’s financial impact: not only is the cost of treatment much less in cancer’s early stages, but people can also continue to work and support their families if they can access effective treatment in time. In 2010, the total annual economic cost of cancer through healthcare expenditure and loss of productivity was estimated at US$ 1.16 trillion.
Strategies to improve early diagnosis can be readily built into health systems at a low cost. In turn, effective early diagnosis can help detect cancer in patients at an earlier stage, enabling treatment that is generally more effective, less complex, and less expensive. For example, studies in high-income countries have shown that treatment for cancer patients who have been diagnosed early are 2 to 4 times less expensive compared to treating people diagnosed with cancer at more advanced stages.
Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health, notes: “Accelerated government action to strengthen cancer early diagnosis is key to meet global health and development goals, including the Sustainable Development Goals (SDGs).”
SDG 3 aims to ensure healthy lives and promote well-being for all at all ages. Countries agreed to a target of reducing premature deaths from cancers and other noncommunicable diseases (NCDs) by one third by 2030. They also agreed to achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. At the same time, efforts to meet other SDG targets, such as improving environmental health and reducing social inequalities can also help reduce the cancer burden.
Cancer is now responsible for almost 1 in 6 deaths globally. More than 14 million people develop cancer every year, and this figure is projected to rise to over 21 million by 2030. Progress on strengthening early cancer diagnosis and providing basic treatment for all can help countries meet national targets tied to the SDGs.
Note to editors:
Most people diagnosed with cancer live in low- and middle-income countries, where two thirds of cancer deaths occur. Less than 30% of low-income countries have generally accessible diagnosis and treatment services, and referral systems for suspected cancer are often unavailable resulting in delayed and fragmented care. The situation for pathology services was even more challenging: in 2015, approximately 35% of low-income countries reported that pathology services were generally available in the public sector, compared to more than 95% of high-income countries.
Comprehensive cancer control consists of prevention, early diagnosis and screening, treatment, palliative care, and survivorship care. All should be part of strong national cancer control plans. WHO has produced comprehensive cancer control guidance to help governments develop and implement such plans to protect people from the onset of cancer and to treat those needing care.
Cancers, along with diabetes, cardiovascular and chronic lung diseases, are also known as NCDs, which were responsible for 40 million (70%) of the world’s 56 million deaths in 2015. More than 40% of the people who died from an NCD were under 70 years of age.
WHO, and the international community, have set targets to reduce such premature NCD deaths by 25% by 2025 and by one third by 2030, the latter as part of the SDGs. Countries have endorsed a range of targets to address NCDs, including making available and affordable basic medical technologies and essential drugs for treating cancers and other conditions in health facilities.
3 FEBRUARY 2017 | GENEVA – New guidance from WHO, launched ahead of World Cancer Day (4 February), aims to improve the chances of survival for people living with cancer by ensuring that health services can focus on diagnosing and treating the disease earlier.
New WHO figures released this week indicates that each year 8.8 million people die from cancer, mostly in low- and middle-income countries. One problem is that many cancer cases are diagnosed too late. Even in countries with optimal health systems and services, many cancer cases are diagnosed at an advanced stage, when they are harder to treat successfully.
“Diagnosing cancer in late stages, and the inability to provide treatment, condemns many people to unnecessary suffering and early death,” says Dr Etienne Krug, Director of WHO’s Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention.
“By taking the steps to implement WHO’s new guidance, healthcare planners can improve early diagnosis of cancer and ensure prompt treatment, especially for breast, cervical, and colorectal cancers. This will result in more people surviving cancer. It will also be less expensive to treat and cure cancer patients.”
All countries can take steps to improve early diagnosis of cancer, according to WHO’s new Guide to cancer early diagnosis.
The three steps to early diagnosis are:
- Improve public awareness of different cancer symptoms and encourage people to seek care when these arise.
- Invest in strengthening and equipping health services and training health workers so they can conduct accurate and timely diagnostics.
- Ensure people living with cancer can access safe and effective treatment, including pain relief, without incurring prohibitive personal or financial hardship.
Challenges are clearly greater in low- and middle-income countries, which have lower abilities to provide access to effective diagnostic services, including imaging, laboratory tests, and pathology – all key to helping detect cancers and plan treatment. Countries also currently have different capacities to refer cancer patients to the appropriate level of care.
WHO encourages these countries to prioritize basic, high-impact and low-cost cancer diagnosis and treatment services. The Organization also recommends reducing the need for people to pay for care out of their own pockets, which prevents many from seeking help in the first place.
Detecting cancer early also greatly reduces cancer’s financial impact: not only is the cost of treatment much less in cancer’s early stages, but people can also continue to work and support their families if they can access effective treatment in time. In 2010, the total annual economic cost of cancer through healthcare expenditure and loss of productivity was estimated at US$ 1.16 trillion.
Strategies to improve early diagnosis can be readily built into health systems at a low cost. In turn, effective early diagnosis can help detect cancer in patients at an earlier stage, enabling treatment that is generally more effective, less complex, and less expensive. For example, studies in high-income countries have shown that treatment for cancer patients who have been diagnosed early are 2 to 4 times less expensive compared to treating people diagnosed with cancer at more advanced stages.
Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health, notes: “Accelerated government action to strengthen cancer early diagnosis is key to meet global health and development goals, including the Sustainable Development Goals (SDGs).”
SDG 3 aims to ensure healthy lives and promote well-being for all at all ages. Countries agreed to a target of reducing premature deaths from cancers and other noncommunicable diseases (NCDs) by one third by 2030. They also agreed to achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. At the same time, efforts to meet other SDG targets, such as improving environmental health and reducing social inequalities can also help reduce the cancer burden.
Cancer is now responsible for almost 1 in 6 deaths globally. More than 14 million people develop cancer every year, and this figure is projected to rise to over 21 million by 2030. Progress on strengthening early cancer diagnosis and providing basic treatment for all can help countries meet national targets tied to the SDGs.
Note to editors:
Most people diagnosed with cancer live in low- and middle-income countries, where two thirds of cancer deaths occur. Less than 30% of low-income countries have generally accessible diagnosis and treatment services, and referral systems for suspected cancer are often unavailable resulting in delayed and fragmented care. The situation for pathology services was even more challenging: in 2015, approximately 35% of low-income countries reported that pathology services were generally available in the public sector, compared to more than 95% of high-income countries.
Comprehensive cancer control consists of prevention, early diagnosis and screening, treatment, palliative care, and survivorship care. All should be part of strong national cancer control plans. WHO has produced comprehensive cancer control guidance to help governments develop and implement such plans to protect people from the onset of cancer and to treat those needing care.
Cancers, along with diabetes, cardiovascular and chronic lung diseases, are also known as NCDs, which were responsible for 40 million (70%) of the world’s 56 million deaths in 2015. More than 40% of the people who died from an NCD were under 70 years of age.
WHO, and the international community, have set targets to reduce such premature NCD deaths by 25% by 2025 and by one third by 2030, the latter as part of the SDGs. Countries have endorsed a range of targets to address NCDs, including making available and affordable basic medical technologies and essential drugs for treating cancers and other conditions in health facilities.
