Patients died cold and uncared for: Health Ombud exposes collapse of psychiatric care in Northern Cape

News24

30-07-2025

The Health Ombud report reveals that two psychiatric patients died and one was left permanently bedridden.
The mental health hospital operated without electricity for year, leaving life-saving equipment useless.
Leadership failures and staff shortages caused the systemic collapse of the patient care system.
The Health Ombud found that two psychiatric patients died and one was left permanently bedridden due to neglect and poor care.
Northern Cape Mental Health Hospital went without electricity for a year, leaving life-saving equipment unusable and patients exposed to extreme temperatures.
These are some of the findings in a damning report by Health Ombud Professor Taole Mokoena, who investigated the treatment, complications and deaths of psychiatric patients at the Northern Cape Mental Health Hospital and the Robert Mangaliso Sobukwe Hospital.
The report cites leadership failures, staff shortages and collapsing infrastructure as the main reasons for the breakdown in patient care.
Emergency machines stood useless as they had not been charged. Calls for help could not go out as the phone lines were down.
Some patients died. Others were sent out in critical condition. One will never walk again.
The investigation followed a complaint made by Health Minister Aaron Motsoaledi in October last year.
The report details how systemic neglect, infrastructure collapse, poor staffing and lack of leadership directly led to suffering, medical complications and death.
Four psychiatric patients were closely examined in the report – two died, one suffered permanent disability and another experienced complications due to poor monitoring.
In his report Mokoena states:
The general care provided was substandard, and patients were not attended to in a manner consistent with the nature and severity of their health condition.
Taole Mokoena
The situation was made worse by a yearlong power outage at Northern Cape Mental Health Hospital, caused by cable theft and vandalism.
While neighboring hospitals had their power restored within days, this one was left without electricity due to delays in the provincial department's supply chain processes.
'Because of the lack of electricity, resuscitation equipment could not be used, heating and cooling systems failed, and patients had to endure extreme weather conditions without proper clothing or bedding.
The report
What happened
Cyprian Mohoto was transferred to Robert Mangaliso Sobukwe Hospital on 13 July last year after he experienced serious complications. A chest X-ray revealed that he had pneumonia, but this was never treated. For three days, his deteriorating condition was ignored by both nurses and doctors. He died on 16 July in the emergency unit.
Tshepo Mdimbaza was found unresponsive in his bed at Northern Cape Mental Health Hospital on 3 August. When staff attempted to resuscitate him, they discovered that the equipment was not prepared or functional. His vital signs had not been properly monitored. A post-mortem found he had died from 'exposure to the elements'.
John Louw, a patient at Northern Cape Mental Health Hospital, suffered a brain injury known as a subdural haemorrhage. After emergency surgery, including a craniotomy and craniectomy, was performed on 7 July and 23 July respectively, complications have left him permanently bedridden.
Petrus de Bruin collapsed in ward M2 at Northern Cape Mental Health Hospital on 30 July and was transferred to Robert Mangaliso Sobukwe Hospital's Emergency Centre. He was stabilised and admitted for hypoglycaemia. While emergency care was appropriate, nursing monitoring was inadequate.
The report highlighted a deep leadership crisis and operational failure at both facilities.
At Northern Cape Mental Health Hospital, there was no emergency preparedness, collapsing infrastructure, poor medicine control, a shortage of staff and a lack of proper record keeping, the report revealed.
The Ombud found that:
The clinical manager had written to the acting head of the provincial department of health, warning about the harmful conditions patients were facing, but no action was taken.
At Robert Mangaliso Sobukwe Hospital, the problems included overcrowding, missing patient files, poor supervision of nurses and staffing shortages across all departments.
'Leadership instability in the Northern Cape provincial department of health negatively affected service delivery, patient safety and the overall quality of care,' said Mokoena.
Recommendations
The Ombud called for urgent action to fix the broken system. This includes:
'This level of systemic collapse must never be allowed to happen again in our health system,' Mokoena added.