Health Ombudsman Malegapuru Makgoba's investigation into the patients' deaths found that inadequate vehicles such as open bakkies were used to transfer patients from Esidimeni. Picture: Jacques Naudé

Johannesburg - The arbitration hearing into the Life HealthCentre Esidimeni tragedy has heard how the health department had no proper plan and not enough resources to ensure the safety and welfare of mental patients during the relocation.

Furthermore, the patients' situation was worsened when the NGOs to which they were transferred to, did not receive grants from the state.

The Gauteng Health Department's chief director of planning Levy Mosenogi, who was in charge of the Esidimeni project, could not supply answers to questions posed to him by Legal Aid's Advocate Lilla Crouse and chairman of the hearing, retired Justice Dikgang Moseneke. 

''Five hundred of them had no identity documents, and nonetheless the contract was terminated and people were moved. People were sent without grants, you told us yesterday that you delayed for three to four months to pay NGOs. The underlying issue here as posed by counsel is that it was irresponsible to do so ... because that placed the patients' lives in danger. Why did this happen? Why did you not prevent that from happening?'' Moseneke asked.

''I was not aware that had happened, that they were moved without IDs ... but we had other facilities to move them to such as Weskoppies and Cullinan."

Crouse lamented the lack of a valid service agreement between the department and the NGOs. If a person is moved without a service agreement with the department, no money can be paid to the NGO concerned, she said.

''If you move people without a service agreement, chances are that patients will suffer because of lack of funds. So in sending patients without an agreement, that would be irresponsible. Do you agree with me?" she asked Mosenogi.

''Yes, mistakes crept in,'' Mosenogi replied.

He added that as a leader of the project, he should have checked to make sure everything was arranged.

''Justice, this was a complex process ... sometimes when you look back, one can say that things should have been done differently.''

Health Ombudsman Malegapuru Makgoba's investigation into the patients' deaths found that inadequate vehicles such as open bakkies were used to transfer patients from Esidimeni. Some of the chronic patients were tied up to the vehicles during the transportation.

Moseneke asked Mosenogi if he managed to find out the common cause of the deaths.

''Some had diabetes, high blood pressure and other chronic diseases. They needed to be looked after ... it was winter and they needed clothes ... all these factors contributed to the condition. They needed to be looked after by qualified people because they were in a new environment, but we did not provide for that,'' said Mosenogi.

''We should have done better. I should have been much more stronger, maybe I should have pulled out after seeing the children's vulnerable position. I regret it all, I regret that people died.''

Moseneke asked: ''Why did the department go ahead with the transfers in the face of all that? Why did the head of department, MEC do it? Maybe you cannot answer for them but why did you as project manager do it? You were warned by specialists, lawyers, families. Why?''

''Going further, the ombudsman came here and told us he was saddened by the fact that state officials, who are paid to do their jobs, were visibly scared of the people they reported to. Were you scared?''

''I was not scared but it was the conditions we worked under. I will raise this in my closing statement that maybe department of health must be run by people who know about health. It would have been far better. Throughout the years in the department, I could reach out to anyone, but it was difficult to reach the MEC ... maybe she was informed differently.''

Makgoba's damning report released in February, found that as many as 94 mentally ill patients who were transferred from Esidimeni to unlicensed care centres died of causes that included neglect and starvation. 

The death toll figure rose over time as more information was discovered by Makgoba, bringing the number of deaths to 118.

Crouse asked Mosenogi if there has been any disciplinary processes against him, to which he replied no.

The arbitration hearing continues.