Minister of Health Dr Aaron Motsoaledi says he feels personally betrayed by what happened with the Gauteng marathon project which resulted in the death of 144 Life Esidimeni psychiatric patients.

"I feel people have been betrayed and I also felt betrayed as the Minister of Health. This has tarnished the health system of the country," Motsoaledi said on Wednesday.

Motsoaledi was testifying during the Life Esidimeni arbitration hearing in Parktown, Johannesburg.

He shed tears during as he testified and said that the project should never have happened.

"It is quite painful and whoever did that must be charged," he said.

"I have never seen such dubious characters," he said, adding that the provincial health department needs to be overhauled completely.

The marathon project involved moving psychiatric patients from Life Esidimeni to various ill-equipped NGOs across the province after the health department terminated its contract with the facility.

This resulted in the death of 144 patients due to dehydration and malnutrition, among other reasons listed by Health Ombudsman Malegapuru Makgoba.

Motsoaledi told the arbitration hearing that the marathon project went beyond embarrassment and added that he was unable to shed light on what happened.

Motsoaledi said he had sent instructions that the affected NGOs must be closed down to prevent more people from dying.

"I was getting tired of people who actually receive bad treatment from health care facilities," he said.

He said he would have gone to court to stop patients from being moved.

"If I had known this disaster would happen, I would have done a lot. I would have [gone] to court.

"[In] hindsight, I [should] have advised the DG to have an order of court."

Asked by Legal Aid advocate Lilla Crouse if he knew why the project had happened, he said: "I have been asking myself the same question for 18 months. There's a lot of criminality in this whole thing. In Parliament they asked if the motive was money...I'm puzzled. I honestly don't know."

"There was a clear intention that officials wanted to hide this from the minister and the premier. But for what reason?"

The hearing is to resume on February 8 and 9 for closing arguments.