The SA healthcare sector is facing a deepening internal challenge as public-sector nurses increasingly engage in unauthorised "moonlighting.", reported Spotlight (8 April 2026).
Due to below inflation wage increases and debt many nurses are taking extra shifts in the private sector without official approval.
For many, the risk of disciplinary action is preferable to the reality of financial insolvency.
In many cases moonlighting results in exhaustion among nurses resulting in severe clinical errors and medical malpractice claims.
At the same time corruption scandals, including alleged multimillion-rand graft at Tembisa Hospital, have eroded trust in leadership and weakened the moral authority to enforce regulations.
Nearly half of nurses are aged 50 or older, intensifying fears of a looming workforce gap. Although Government aims to train 34,000 professionals by 2030, experts argue meaningful salary increases and improved working conditions are essential to stabilise the system.