The local government Minister for Health in Gauteng, South Africa’s wealthiest province, resigned on Tuesday, January 31, just before the release of a report into the deaths of 94 mental health patients.

Qedani Mahlangu’s post is the equivalent of a health minister but at provincial level.

She faces a class action lawsuit after a report by the health ombudsman exposed the appalling conditions in which the psychiatric patients died between March 23 and December 19.

The patients died because of a cost-cutting exercise by the Gauteng government.

A total of 2 000 patients were moved from Life Esidimeni private hospitals to 27 NGOs. The report stated that they all operated under invalid licences.

All patients who died in these NGOs died under unlawful circumstances.

It was initially reported that 36 patients had died, but the figure turned out to be nearly triple that. The health ombudsman found that the most common cause of death was pneumonia, followed by uncontrolled seizures.

Patients were also found to be starving and dehydrated. Relatives testified that the patients had been given no blankets or warm clothing during last year’s cold winter.

The patients died on average two months after the hurriedly and haphazardly arranged transfers took place.

The report has been met with outrage and shock. In addition to the Gauteng Health MEC’s resignation, the suspensions of two other senior officials have also been recommended – the head of health and a senior director.

Both are registered medical doctors.

The report stated that the MEC’s and the two officials’ fingerprints were “peppered” throughout the project.

The events have raised two important issues – the extent of responsibility by political appointees, such as the MEC, as well as the problem of medical doctors having “dual loyalties”.

This exists where medical professionals are employed by, for example, the state or defence force.

South Africa has a particularly brutal case of “dual loyalty” that underscores why it’s vital doctors remember their first responsibility is to their patient’s well-being, interests and safety.

In other words, the needs of their patients must supersede any demands placed on them by their employer.

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