Health Ombud completes 10 861 complaints during tenure

Wednesday, May 31, 2023

The outgoing Health Ombudsman, Professor Malegapuru Makgoba, announced on Wednesday that his office completed 10 861 complaints in the past seven years, including the most talked about Life Esidimeni Tragedy.  

According to Makgoba, the Life Esidimeni Tragedy -- which probed the circumstances surrounding the deaths of mentally ill patients -- has become the standard on how a Health Ombud conducts investigations. 

“I often said to my team, you must focus on quality. The high-profile cases have taken us six months to investigate, and we can’t say, because these [Life Esidimeni] senior officials aren’t in jail, there haven’t been any consequences.

"There have been many consequences from the report, with senior officials losing their jobs and reputation.” 

Currently, an inquest is underway at the Pretoria High Court that will determine whether anyone can be held criminally liable for the death of 141 mental healthcare patients after being transferred to unlicensed non-governmental organisations (NGOs) from Life Esidimeni facilities.  

Makgoba, who was appointed as the first Health Ombud in South Africa in 2016 for a non-renewable term of seven years, was reflecting on his tenure. Today was his last day in office.

The outgoing Health Ombud also dealt with the Tembisa Tertiary Hospital after the office found that the facility was negligent, leading to the death of businessman Shonisani Lethole.

Makgoba also recently released a report on Rahima Moosa Mother and Child Hospital (RMMCH), which found that the paediatric and child health facility was unsafe and that the CEO was unfit for the job.

Taking media through his journey, Makgoba recalled how he had to think on his feet about the task ahead.  

He said he had to take into account the legal framework, governance, budget and staffing issues.

“I scanned literature throughout the world and discovered a simple thing that these offices have always been independent and standalone, and sometimes governed by the President or sometimes the Parliament of the country.

“I had to socialise that concept and now this principle is accepted that the office of the Health Ombud should be a separate office, independent and have a proper mandate. So, I spent my time trying to do that,” he recalled.

He stressed the importance of the office being independent. 

Makgoba said none of the Health Ministers, including Dr Aaron Motsoaledi, who appointed him, has ever influenced his findings or recommendations, even when they were implicated.

“I say this because political interference is a common phenomenon in South Africa.”


The Professor also had to create an office of investigators from scratch. 

“We had to train them to become competent to make fair and just recommendations. For me, what was important is that we have investigators who are in keeping with how medicine and health are evolving.”

The office now boasts a panel of experts who investigate any matter, from COVID-19 to psychiatry-related issues. 

Of over the 10 000 complaints handled, which Makgoba said could have been more had he had more staff, 50% were from Gauteng.

“The smallest province, the densely populated and economic hub of our country, generated the most number of complaints,” he said.

The Health Ombud findings also had to undergo some scrutiny and face court and legal battles. 

“But I’m happy to report that in the seven years that this office has been established, there have been appeals and court challenges of our findings and recommendations, none of the appeals succeeded, was set aside or overturned by the courts or tribunal. I think that is the testament of the investigators and investigations that they do.”

Lack of leadership

Makgoba named the Eastern Cape and Gauteng as the provinces with the most dysfunctional health departments, while Free State is not far from the two.

The common thread in the Eastern Cape and Gauteng public health sector is the lack of leadership, constant change of CEOs and disorder.

Meanwhile, Makgoba found the Western Cape has managed to get their house in order over the years.  

“I couldn’t do everything I wanted to do and don’t regret it. This is a new office and it is on a journey.

“I had a good time and enjoyed myself. I had challenges, but if you dwell on challenges, you will end up in a mental hospital,” he concluded. –