The Life Esidimeni inquest has heard how the charges it billed to the Department of Health ballooned over the years.
The inquest, which is being heard virtually in the Pretoria High Court, resumed on Monday following a four-week break.
The inquest is investigating whether criminal proceedings should be instituted against anyone linked to the deaths of 144 Life Esidimeni patients, who died after being moved to various non-governmental organisations (NGOs).
Returning to the stand on Monday was former Life Esidimeni managing director Morgan Mkhatshwa.
He testified last month.
On Monday, Mkhatshwa faced questions from Laurence Hodes, the legal representative of former Gauteng MEC of Health Qedani Mahlangu.
Hodes’s questions focused on Mkhatshwa’s knowledge of the strategy developed by the national Department of Health to deinstitutionalise mental care.
The strategy had been termed “the 2013 to 2020 strategy”.
Hodes attempted to ascertain whether Mkhatshwa had known that Mahlangu had not been involved when the strategy to change mental healthcare had been adopted.
Mkhatshwa maintained that he did not have regular communication with Mahlangu, but interacted with the department’s head of mental health.
At the time, the Department of Health had motivated for the relocation of hundreds of mentally ill patients from Life Esidimeni to NGOs in order to cut costs.
Hodes questioned Mkhatshwa on the ballooning costs charged by Life Esidimeni to the health department.
The institution had been housing mentally ill patients for more than 30 years.
The facility housed slightly more than 2 000 mentally ill patients.
The evidence presented by Hodes showed the department was charged R209 million between 2011 and 2012.
From 2012 to 2013, the costs had risen to R224m, and from 2013 to 2014, the costs were more than R251m.
By 2015, the costs had ballooned to a total of R323m.
Hodes further questioned Mkhatshwa about the rising costs and how the institution justified charging so much money, with costs rising by 37% in some instances.
Mkhatswa attempted to justify the rise in costs, saying there were never the same patients at all times at the institution.
He also insisted that there were years in which Life Esidimeni was not given an opportunity to increase its prices, despite rising costs.
He said price increases had to be looked at broadly, and in many instances, they were backed by a rise in the Consumer Price Index (CPI).
“An annual tariff increase was negotiated by Esidimeni and the Department of Health. CPI had an influence on how much the percentage increase would be.
“There were certain years that we struggled to get tariff increases. All those factors would need a clear analysis to be done,” Mkhatshwa said.
According to Mkhatshwa, the Department of Health had at times failed to honour payments, and Life Esidimeni had been left to cushion the costs to continue housing patients at the facility.
The inquest will resume.
Political Bureau