Gauteng Health MEC resigns

Wednesday, February 1, 2017

Pretoria – Qedani Mahlangu has tendered her resignation as the Gauteng MEC of Health and a member of the Gauteng Provincial Legislature following the release of a report into circumstances surrounding the deaths of mentally ill patients in the province.

Dubbed "No Guns: 94+ Silent Deaths and Still Counting," the report, which was released on Wednesday, revealed that 94 mentally ill patients died after being removed from Life Healthcare Esidimeni to 27 NGOs.

In late 2016, Health Minister, Dr Aaron Motsoaledi, requested the Health Ombud, Professor Malegapuru Makgoba, to investigate the circumstances surrounding the deaths of these patients in Gauteng and advise on a way forward.

The report found that all the 27 NGOs to which the patients were transferred operated under invalid licenses and all patients who died there, died under unlawful circumstances.

Releasing the report on Wednesday, Makgoba said the number of deaths (94) is provisional, as there are still unidentified bodies in morgues and some families are still coming forward with the names of dead people.

“On 13 September 2016, when the MEC made the public announcement of 36 deaths, 77 patients had already died. The Gauteng Directorate of Mental Health (GDMH) could only identify 48 deaths.

“Between May and September 2016, 77 MCHUs (Mental Health Care Users) died. The OHSC (Office of Health Standards Compliance) inspectors and Ombud identified and confirmed 73 deaths, while the Ministerial Advisory Committee on Mental Health identified and confirmed 66 deaths during the course of their investigations,” Makgoba said.

At the time of writing the report, 94 patients had died in 16 NGO facilities and hospitals.

Gauteng Mental Health Marathon Project

The report identified MEC Mahlangu, Head of Department (HoD) Dr Tiego Ephraim Selebano and Director, Dr Makgabo Manamela, as three key players in the Gauteng Mental Health Marathon Project (GMMP). 

Reading from the report, Makgoba said: “... The project was done in a hurry, with chaotic execution in an environment with no developed, no tradition, no culture of primary mental health care community-based services framework and infrastructure.

“Mentally ill patients were transferred ‘rapidly and in large numbers with a short timeframe’ from the ‘structured and non-stop caring environment’ of Life Esidimeni into an ‘unstructured, unpredictable, sub-standard caring environment’ of the NGOs.

“This decision was not only negligent and a violation of the rights of the mentally ill patients, but also goes totally against the principle of health…”

Makgoba said that only one patient died from mental health illness, while some died because they were not well when they were received by the subsequent facilties. Some had diarrhoea, chronic conditions such as TB and hypertension, while others suffered heart attacks.


The Ombud recommended that the Gauteng Mental Marathon Project be de-established, and Gauteng Premier David Makhura consider the suitability of Mahlangu to continue in her current role as MEC for Health, among others.

It also recommended disciplinary proceedings against Dr Selebano and Dr Manamela for gross misconduct and/or incompetence in compliance with the Disciplinary Code and Procedure applicable to SMS members in the Public Service.

“The findings against Drs M Manamela and TE Selebano must be reported to their respective professional bodies for appropriate remedial action with regard to professional and ethical conduct,” the Ombud recommended.

He also recommended corrective disciplinary action for the implicated Deputy Directors and Chief Director for failing to exercise their fiduciary duties and responsibilities. 

Review of NGOs

The report further recommended that the National Department of Health must review all 27 NGOs involved in the Gauteng Mental Health Marathon Project.

“Those that do not meet healthcare standards should be de-registered, closed down and their licences revoked in compliance with the law. The National Minister of Health must with immediate effect appoint a task team to review the licensing regulations and procedures to ensure they comply with the National Health Act, the Mental Health Care Act 2002 and Norms and Standards. 

“The newly established process must ensure that NGO certification is done through the OHSC. This newly established licensing process should form the first line of protection for the mentally ill.  Currently, this does not seem to be the case.”

Gauteng Premier commits to act

Premier Makhura welcomed the release of the report. He said he will fully and urgently implement its recommendations without any reservation or delay. 

“It is clear from the report that there has been both improper and negligent conduct on the part of officials in the Department of Health in the implementation of the policy of de-institutionalisation of mental health.

“On 6 December 2016, I made a commitment in the Gauteng Legislature in which I expressed my unhappiness with how the de-institutionalisation was handled. I promised should the investigation find that there was improper conduct or negligence, action will be taken to hold those responsible accountable,” said Premier Makhura.

The Premier also accepted Mahlangu’s resignation and announced the appointment of former Deputy Minister of Health and former MEC for Health, Dr Gwen Ramakgopa, as the new MEC for Health.

Minister Motsoaledi welcomed the recommendations of the report. Those implicated in the report have 30 days to launch an appeal against the findings. –   

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