Suspended head of the Gauteng health department, Barney Selebano, has admitted that he "didn't fathom that such a tragedy could take place," conceding that his department did not follow advice.
"We did things wrong by not heeding to advice, by not listening to other people," he said.
It was his second day giving evidence at the Life Esidimeni arbitration in Parktown, Johannesburg on Wednesday.
Selebano said that he took responsibility for the "regrettable" deaths of more than 140 mentally ill patients who died when they were moved to different ill-equipped non-governmental organisations (NGOs) across the province.
"I take accountability. It happened under my watch. There is no way that, if you are a leader and something happens, and then you suddenly want to walk away from it," he said.
Selebano told the hearing that the deaths took place because of the negligent conduct of the department that he headed.
The former health head, who referred to the move as a "revenue enhancement programme" denied that he knew that the rushed and ill-conceived move would result in fatalities.
"If I had known that there would be mortalities - I wouldn't have guessed that - if I had known, then really that would have been unthinkable, that I would have gone on," he said.
It was again revealed that he, along with other senior officials, had more than one warning about the dire consequences of moving mentally ill patients from Life Esidimeni to NGOs. Warnings came in the form of legal action, media coverage, family and civil organisation complaints.
Furthermore, an extensive report costing R400 000, compiled by the Health Advanced Institute (HAI), revealed that the service offered at Life Esidimeni was good value for money and the institution was financially efficient. The report was paid for by the department.
Collective decision makers
Former deputy chief justice Dikgang Moseneke said Selebano should have taken steps to avoid all harm, even if he couldn't have foreseen the tragedy.
"The warnings came, but one wishes they could wind back the time and act differently. I am not defending it or saying we acted in the right manner, but the warnings were clear... although they never said there would be fatalities," he said.
The warnings came before he signed the contract which terminated the contract between Life Esidimeni and the department in September 2015.
Selebano stuck to his guns, saying that the decision to end the contract with Life Esidimeni was made by a collective group after extensive meetings between 2014 and 2015.
He named former MEC, Qedani Mahlangu, directors, chief directors, chief executive officers (CEOs), deputy director generals, head of mental health Makgabo Manamela and himself as the collective decision makers.
Selebano reluctantly testified after being cornered that the mental healthcare unit - headed by Manamela - authored the letter that he signed to terminate the contract.
He said he was told that the contract had been there since 1977, was operational in the whole country, and was one of the supply chain reasons behind the termination, which he mentioned on Tuesday.
It emerged previously that although Selebano said the department made the decision because they were cash-strapped and needed to relieve financial pressure, they were able to buy Life Esidimeni.
Moseneke said the department could have put it out to tender instead of terminating at the expense of the vulnerable.
Selebano continues his testimony on Thursday.