Life Esidimeni justice is unlikely

It’s the old and tested South African recipe on how to minimise accountability or possibly avoid it completely.

Cover with loads of bureaucratic manure. Apply plenty of well-intentioned hot air from ombuds, mediators, and arbitrators. Then saturate with platitudes from ANC politicians. Leave to simmer for as long as possible. Lift lid. Voilà!

An unappetising, undigestible mush. Nothing substantial to gnaw on.

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It is now eight years since the Life Esidimeni tragedy in which at least 144 psychiatric patients died under cruel circumstances.

This week, after three years of desultory proceedings, Judge Mmonoa Teffo delivered her inquest findings.

She ruled that two government officials – former Gauteng health MEC Qedani Mahlangu and Dr Makgabo Manamela, former head of mental health in Gauteng health – were legally liable for the deaths of at least nine patients.

The inquest finding is by no means the end of a saga that started in 2016.

As a cost-saving measure, Gauteng health department had in that year decided to move 1 606 mental patients from Life Esidimeni’s private health facilities into “community care Through a process that has never been adequately investigated, 27 NGOs were chosen to receive 1 039 patients.

They were all illegal entities: unregistered and uninspected. Within three months, there were signs of an unfolding human disaster that Gauteng health dismissed with mockery.

It was only after public pressure became unbearable that Mahlangu in September 2017 admitted that 36 patients had died.

Health ombud Prof Malegapuru Makgoba launched an independent investigation and released a report in February 2017 that fixed the death toll at 94.

Over the following months, it became apparent that this, too, was an underestimate. The death toll has since been established to be at least 144 patients.

Keen to deflect blame and minimise political fallout, the ANC appointed former deputy chief justice Dikgang Moseneke to arbitrate an alternative dispute resolution between the Gauteng government and the victims and their families.

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At the end of it, the state paid R450 million in compensation and damages. So, on the face of it, the Teffo judgment is good news.

It forces the National Prosecuting Authority (NPA), which in 2019 reported that it did not have enough evidence to bring charges against anyone, to at least pretend to think again.

Mahlangu and Manamela are unlikely to be losing sleep over the Teffo judgment. They know from experience that the NPA is unwilling to act against them.

Especially fortunate is Dr Tiego Selebano, former head of Gauteng health, who, with Mahlangu, and Manamela approved and oversaw the plan.

The Makgoba report describes the triumvirate as the ones whose “fingerprints peppered the project”. Inexplicably, he has totally avoided Teffo’s censure.

The Health Professions Council of SA and the SA Nursing Council, medical and nursing oversight bodies, have also failed the victims.

Despite recommendations from Makgoba and Moseneke that several nurses and doctors should be disciplined, nothing much has happened.

Despite 144 dockets being referred to the NPA by the police and the Special Investigating Unit (SIU), not a single prosecution was brought.

The SIU did, however, reportedly claw back R5 million of state payments made to the NGOs. There has been no political accountability either.

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The Gauteng premier at the time, David Makhura, was implicated by witness testimony in the decision to cancel the Life Esidimeni contract.

Consequently, there was talk that he would be subpoenaed to give evidence before the Teffo inquest. This did not happen.

Instead, Makhura cruised along in the premiership through to 2022, unaffected by the scandal that happened on his watch.