Health MEC breaks her silence on psychiatric patients

Health MEC breaks her silence on psychiatric patients

In June 2015, Gauteng health MEC, Qedani Mahlangu, announced that the department would terminate its contract with private hospital group, Life Healthcare.

The private healthcare provider had housed almost 2,000 long-term, state-funded psychiatric patients at its Life Esidimeni facilities in Johannesburg.

Patients would either be sent home or transferred into the care of community–based nongovernmental organisations, said Mahlangu. At least 36 patients have died following the move.

Source: M&G/Felix Dlangamandla

Source: M&G/Felix Dlangamandla

Last week, dozens of activists from organisations such as the Treatment Action Campaign (TAC) and public-interest law organisation Section27 joined affected families in a protest outside the Gauteng health department and handed over a list of demands.

This week, Mahlangu discussed the department’s response to the deaths and why the matter may prompt court cases on both sides.

Can you explain the rationale behind the move?

We’ve been through that. I should start by saying we have met with a lot of people and the majority of them were at the march.

When people take things to the street as if there is no engagement with the department, it worries me as to what exactly is the intention of this.

A number of patients … because their psych conditions could not be managed at NGOs (nongovernmental organisations), those [patients] were sent to Sterkfontein [psychiatric hospital], to Weskoppies [psychiatric hospital] and some to the Cullinan [care and rehabilitation] Centre.

We’ve employed additional nurses … and we are also reviewing the amount of money we spend on patient care.

How were NGOs identified and vetted?

From September, I started visiting the NGOs. Before that … I would not have visited NGOs and I don’t think it would be my responsibility as an MEC.

The mental health team would have decided [on] these NGOs. The report we received would say something like: “This NGO qualifies.”

How will the department improve the monitoring of mental health facilities?

These scheduled weekly visits by our team are important but [we will be doing] more unannounced visits. I have said to some of the NGOs like the TAC that I am going to invite you to the NGOs when I go there. We’ve also said to our hospitals that where they have a [nearby NGO operating], medical doctors, not only psychologists, must … visit those places to medically assess patients.

A memo delivered to the department asked for a list of the NGOs housing former Life Esidimeni patients and the number of patients who have died. Will you be responding to the demands?

We will respond to the issues that are practical to respond to. One thing that is impossible to do is to share details of family members without their consent — that we can’t do. Section27 has asked us for the list [of NGOs and patients].

Section27 wants to sue the department, so they want the list for that purpose. They’ve said it in our formal meeting with them. They came with their lawyers; we came with ours.

How many NGOs still house former Life Esidimeni patients?

Sho, I wouldn’t know off the top of my head … Probably more than 10.

You’ve mentioned possibly taking legal action yourself. Why?

Where my name has been used inappropriately in certain things, I will definitely be able to do so. I am working with lots of people who work exceptionally hard and sometimes they will make mistakes. Things go wrong sometimes, [but] the question is how do you learn from the mistake?

 

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BY: LAURA LOPEZ GONZALEZ

New head of the Gauteng Department of Health appointed

Dr Barney Selebano has been appointed as the new head of the Gauteng Department of Health by Gauteng Premier David Makhura.

Dr Selebano holds a BSC Honours in biochemistry from the university of Limpopo along with and MBCHB from Medunsa. He also has a Management Advancement Programme from WITS.

Dr Selebano has worked in senior position public and private for many years until his appointment to as the Deputy Director General of Clinical Services. HE also held to position as acting Head of the Department since October 2014.

The Gauteng Provincial Government hopes that his appoint will move to stabilise the Department. While bringing much needed achieve the Departments goals for the province of Gauteng.

Provinces slow to prioritise NCDs

imagesOnly 3 provinces have draft (not officially approved) NCDs plans and none have a budgetary allocation that can be traced to NCDs. Assessing the extent of NCDs roll out is difficult as neither budgets nor monitoring mechanisms are available. The three provinces are Gauteng, KwaZulu-Natal and Mpumalanga (see Table 1).

No province meets the all of the criteria for an operational NCDs plan:

  • NGOs & PLWNCDs engaged in national NCD plan development
  • Provincial budgetary allocation for prevention and treatment
  • Intersectoral NCDs mechanism including NGOs, PLWNCDs and private sector
  • NCDs plan with a ‘whole of government’ approach, i.e. with areas for action beyond the health sector.

NCDs plans could be standardised if a template existed and that could easily be one of the first tasks of the long delayed NCDs Commission / National Health Commission.

Discouraged NCDs personnel in provinces

Dedicated health officials from the provincial heath head offices work on NCDs despite the low priority given by leaders to fight NCDs. One such worker recently said: “I have been told there is no budget for NCDs health promotion in our province for the rest of the financial year. What am I supposed to do for the next 5 months? It is very discouraging.”

Table 1:  NCDs plans available and operational in provinces

Eastern Cape: Unknown No web-based documentation found and no response to request for NCDs plan.
Free State Unknown No web-based documentation found and no response to request for NCDs plan.
Gauteng: Partial Completed draft NCDs operational plan that is combined with geriatrics and eye care. (26) Goals, targeted and with budget request. Intersectoral objectives with meetings and district coordinators already take place. Availability of plan not known.
KwaZulu-Natal Partial Completed draft NCDs plan used to guide activities which presented at the intersectoral KZN–SA NCD Alliance Indaba (workshop) in June 2014.(27). However, support is implied by the attendance of the Member of the Executive Committee (MEC) for Health at the NCDs meeting. (28)
Limpopo: unknown No web-based documentation found and no response to request for NCDs plan.
Mpumalanga partial Completed draft NCDs Operational Plan 2014 (29)
North West unknown No web-based documentation found and no response to request for NCDs plan.
Northern Cape unknown No web-based documentation found and no response to request for NCDs plan.
Western Cape partial Plan under construction. (30)

Source: SA NCD Alliance Benchmarking NCDs for action 2015.  Full list of references in benchmarking document (all are all provincial government documents.)