For families of more than 100 mental health patients who died after being shunted from state-subsidised care, justice remains a waiting game as they allege the South African Police Service has yet to charge anyone in connection with the deaths.

Christine Nxumalo’s sister Virginia was one of the almost 1400 mental health patients removed from state-subsidised care at private Life Esidimeni facilities in 2016 to save costs. Virgina was also one of more than 100 patients who died as a result.

Nxumalo says she opened a case regarding her sister’s death in September but has not heard anything from investigating officers.

“It’s a concern on our side that the South African Police Services (SAPS) have been dangerously slow to respond to inquests,” she says.

“My case was [opened] long ago in September 2016 as you can see quite a bit of time has gone by, and nothing has been done. I still have not received [my sister’s] post-mortem results, and I know a lot of other people who haven’t received results,” Nxumalo explains. She says many families are waiting for autopsy reports to confirm their suspicions that Life Esidimeni patients did not die of natural causes as stated on current death certificates but rather from conditions relating to neglect.

She says that in response to families’ concerns, Gauteng premier David Makhura and health MEC Gwen Ramokgopa have agreed to help fast-track investigations.

SAPS had not responded to requests for comment at the time of going to print.

In 2015, former Gauteng health MEC Qedani Mahlangu announced her intention to move almost 1400 mental health patients out of subsidised care and largely into that of community-based organisations to save money. Mahlangu encountered huge public opposition but went ahead with her decision. Experts, families and activists warned that the organisations could not provide the high-level care most Life Esidimeni patients needed.

She resigned in February on the eve of the release of a damning report by the health ombudsman that found her decision to relocate patients had been tantamount to negligence. The ombudsman also found that multiple, high-level Gauteng officials had ignored warnings about the project and hid evidence of wrongdoing.

Life Esidimeni families remain concerned that many who were involved in what was known as the “Gauteng Mental Health Marathon Project” remain employed in the department, Nxumalo warns.

Since February, the Gauteng health department in consultation with Nxumalo and other Life Esidimeni family members has relocated 820 people out of community-based organisations and into state or private facilities, according to public interest law organisation Section27, which has been representing many of the families.

Nxumalo says 29 patients remain in the care of unlicensed nongovernmental organisations at the behest of their families, who feel these organisations are providing patients with adequate healthcare.

“They don’t trust the government, and they feel that their patients are stable there,” she explains.

But Nxumalo and others now say that the Gauteng health department has yet to enter into formal contracts with the Clinix Selby Park Hospital and Life Esidimeni facilities that are now housing patients.

“We are concerned that the absence of service-level agreements puts mental health care users at risk somehow because how do we hold them to account if something goes wrong in those facilities,” says Nomvula Nojabe, whose sister was recently relocated out of community-based care.

The Gauteng health department declined to answer questions regarding the delays in contracts as well as how much facilities would be paid to provide care and for how long. The department did, however, say it was aware of concerns regarding contracts among Life Esidimeni patient families. 

Life Esidimenimental health