The hidden millions in healthcare: why Sunshine legislation matters

Summary

In this blog, Kath Sansom, founder of Sling the Mesh, argues that Sunshine legislation, which requires pharmaceutical and medical device companies to publicly disclose payments to healthcare professionals and organisations, is essential for improving transparency and patient safety. She highlights concerns that undisclosed financial relationships can influence research, prescribing and treatment recommendations, potentially leading to patient harm.

Content

Most of us trust that when a doctor recommends a treatment, medicine or medical device, that advice is based on the best available evidence.

But what if the people researching, promoting or recommending those treatments are receiving money from the companies that make them?

That's where Sunshine legislation comes in.

Sunshine legislation shines a light on transparency of who is paying who. It means companies that make medicines and medical devices must publicly declare payments they make to doctors, researchers, hospitals, charities and healthcare organisations. The idea is simple: let the public see where money is going so everyone can make informed decisions.

This might sound like a niche issue that only affects politicians, doctors, researchers or journalists, but it affects all of us. Every one of us is a patient or will be one day.

Why does transparency matter?

Let's be clear. It is not all bad that doctors and researchers working with industry. Many medical breakthroughs happen because experts and companies work together.

The problem is when financial relationships are hidden or difficult to find. And they are not declared.

Imagine a social media influencer recommending a anti-wrinkle face cream without telling followers they are being paid to tell you how amazing it is by the makers of the anti-wrinkle face cream. Most people would agree that it is misleading. The same principle applies in healthcare.

If a healthcare professional receives funding from a company, the public should be able to see that information. It doesn't automatically mean their judgement is compromised. It simply allows openness and scrutiny.

Transparency matters because financial interests can sometimes influence how research is presented. It can lead to benefits being overstated and risks downplayed. It can affect how treatments are promoted and lead to prescribing bias. When that happens, patients can lose out.

What has this got to do with the mesh scandal?

For members of Sling The Mesh, transparency is not an abstract policy debate. It is a patient safety issue.

Thousands of women have suffered life-changing injuries after being implanted with pelvic mesh devices. Many believe financial relationships within healthcare contributed to a culture in which risks were downplayed and concerns from patients were ignored for years.

The Independent Medicines and Medical Devices Safety Review, led by Baroness Julia Cumberlege, listened to the experiences of women harmed by pelvic mesh, as well as families affected by sodium valproate and Primodos.

Its landmark report, First Do No Harm, concluded that healthcare needed greater openness and transparency. One of its recommendations (8b) was for better disclosure of payments from industry to healthcare professionals and organisations.

What is happening now?

Surprisingly, the UK still does not have a full Sunshine-style system unlike many other countries, including America, Belgium, France and Japan.

In the UK pharmaceutical companies operate a voluntary disclosure scheme, meaning companies choose whether and how to report certain payments. In 2025 a whopping £929million flowed from industry to the UK health sector. Medical device companies are not covered by an equivalent system.

Around 70% of the pharmaceutical industries disclosures made to the Disclosure UK database are for research payments—and these are logged as bulk totals rather than individual payments, making it hard for patients, journalists and researchers to see where the money has gone. 

Information is also scattered across different sources, which means there is no single place where the public can easily search and understand financial relationships across healthcare.

Why should people care?

Because healthcare decisions affect everyone.

Whether it is a medicine prescribed for mental health, a contraceptive device, treatment for a sports injury or care for a family member, you have a right to know that decisions are being made as transparently as possible.

We already expect transparency from politicians. MPs must declare gifts, payments and financial interests because the public has a right to know about potential conflicts of interest.

Healthcare should be held to the same standard.

What is Sling The Mesh calling for?

The campaign is asking for a UK Sunshine law that would require the disclosure of all industry payments to the health sector.

It also wants:

• A single government-run, searchable database.

• Reporting of all payments, including research and development funding.

• Individual payment reporting rather than large lump sums.

• A system that is mandatory, not voluntary.

The goal is not to stop collaboration between industry and healthcare. The goal is to make those relationships visible so they can be properly understood and independently scrutinised.

Patients avoidably harmed by healthcare scandals have waited more than a decade for meaningful transparency reform.

The opportunity now exists to deliver the recommendations of First Do No Harm and strengthen patient safety for our children and grandchildren.

The bigger picture

At its heart, this is about trust.

Medical innovation saves lives. New medicines and medical devices improve lives every day. But innovation works best when it is matched by transparency.

The lesson from the mesh scandal is that patient safety cannot rely on trust alone. There must also be accountability.

When the public can see who is being paid, where the money comes from and how decisions are being made, confidence in healthcare grows stronger.

That's why Sunshine legislation matters. Not just to campaigners. Not just to doctors. But to everyone who will ever sit across from a healthcare professional and seek advice about their health.

Because transparency and patient safety should always go hand in hand.

About the author

Kath Sansom is founder of Sling the Mesh, the campaign group she set up after she was harmed by pelvic mesh surgery.