The truth about private health scans There's a risk of over-diagnosis

Private health checks used to be the preserve of wealthy CEOs. But with NHS waiting lists stretching into years, Neko Health has stepped in for the masses. In a blaze of publicity, the Swedish company has set up a new clinic in Marylebone, offering tests billed as “a health check for your future self”. The clinic is Insta-friendly, offering minimalist chic and sleek photogenic gadgetry. All curved cream chairs, pastel walls and softly lit scanning rooms, it seems more like a spa than a medical centre, and is certainly a far cry from your typical NHS hospital.

Cofounded by Hjalmar Nilsonne and Daniel Ek, one of the billionaire founders of Spotify, Neko now boasts various influencers posting reels of their health check, which cost £300 a pop. That hefty asking price comes with some big claims about what the firm can do: Neko claims their scans have led to “potentially life-saving” healthcare. Nor are they alone. Longevity has become an obsession for a range of tech titans. Sam Altman and Peter Thiel are just two examples here, even as other firms are springing up to imitate Neko’s model.

Fundamentally, these ideas are rooted in logical, predictable input-outcome systems which primes people to apply the same mechanistic thinking to the complexities of human biology. But the human body is more than a “complex computer”. Tech enthusiasts, driven by a relentless march of progress in processing power and engineering, can harbour a blind faith in cutting-edge medical technologies — an approach that can sometimes do more harm than good both to patients themselves and the NHS at large.

At the heart of Neko’s platform is a full body check, aimed at seemingly healthy people, using around 70 different sensors alongside a mix of proprietary and off-the-shelf technologies. Together, they non-invasively photograph every inch of a patient’s body. To quote Ek: “The visual metaphor early on was around the airport scanner.” On their website, Neko explains that they scanned just under 3,000 people in 2023, of whom 14.1% required medical treatment. At the same time, Neko say that 1% of their patients received potentially life-saving treatment for severe conditions like cardiovascular diseases, severe metabolic diseases, and skin cancer, and that “none of these individuals was aware of their condition prior to their visit”.

These results come with the caveat that this is “not a scientific study with a control group for comparison” — but they “would like to share our outcomes for transparency and knowledge sharing”. That’s arguably fair, especially given the NHS is in such trouble at the moment. With so many people simply struggling to get through to their GPs on the phone, Neko offers results in “under an hour” and is “accompanied by substantial in-person time with a doctor”.

Yet there are problems here. For one thing, there’s an inbuilt inaccuracy risk. Some people will inevitably have what’s known as a “false positive” result: they won’t actually have the disease they were tested for. This means at least two things. First, patents risk becoming stressed unnecessarily. Second, they risk being investigated for ailments that aren’t actually there.

Even so, the “earlier is better” political mantra is a boon to those companies jumping on the early detection bandwagon. A spokesperson for Neko told UnHerd that NHS leaders, together with Health Secretary Wes Streeting, have “emphasised the importance of preventive care using modern technology to improve healthcare outcomes”. But true preventative healthcare is stopping problems before they start — not finding them early. That involves the boring but sensible stuff: eating a varied, plant-heavy diet; not smoking; not drinking excessively; being a healthy weight and doing reasonable amounts of varied exercise.

At the same time, Neko told us that the NHS provides “the most basic options, available only to individuals of specific ages and at certain intervals”. They, on the other hand, claim a comprehensive service delivered at speed. But this is to misunderstand the early detection — or screening — programmes that the NHS does offer. These breast, cervical, bowel, aortic and newborn health assessments have been tested to ensure they do, on balance, more good than harm. And it’s not just about the risk of false positives. It’s also whether the tests deliver information that’s useful, rather than simply being a data dump.

Investigate Neko’s offering and there are other worries too. That talk of sensors and non-invasive photographs is certainly reassuring — but the claims that the firm’s scans have led to “potentially life saving” healthcare are impossible to prove because they have no control group. While 1% of their patients received potentially life-saving treatment, we don’t know what would have happened without the screening, and whether any interventions really did help.

Dr Minna Johansson is a Swedish family doctor and head of the Global Center for Sustainable Healthcare. A few years ago, she was invited to meet Nilsonne and Neko’s head of research to discuss the company’s offerings. In the end, though, Dr Johansson was unimpressed. “There are recognised scientific methods for evaluation of screening — which they seem to be totally unaware of,” she tells UnHerd. “The data they are gathering is quite useless for evaluating the benefits and harms of their intervention.”

In any case, some Neko services are already available in the NHS. That includes cholesterol and blood pressure tests — even as some Neko offerings simply haven’t been shown to give health benefits. Among other things, the NHS doesn’t recommend blood count or ankle blood pressure tests for healthy people. This isn’t because the health service is tight with money: some patients were tested in randomised trials, yet the results showed no benefit. As Johansson adds, other tests have never been properly evaluated or tested, so there’s no good evidence to think they’ll save lives.

The upshot? That people who do go to Neko may be falsely reassured that certain behaviours — too much alcohol; too little exercise — aren’t adversely affecting them. As Johansson puts it: “Based on the best available evidence, I would say that it is more likely that this is a waste of money and time: and there is an obvious risk that the individuals buying this intervention will be harmed through overdiagnosis and overtreatment.”

Undeterred, Neko Health is seeking to expand their user base. To quote their website: “Build upon your data. Every year.” Given three quarters of their customers apparently book a repeat test, this approach does seem successful, even as Ek has claimed his scheme is ultimately philanthropic. “I would be super happy if this turned out to make me no money, but we actually solved real issues in the world for real people.”

Perhaps. But turning testing into a rolling investment is catnip to companies looking for long-term gain. Certainly, other firms are entering the fray beyond Neko Health. Numan, a digital health company, offer a “fear nothing blood test” with big billboard-style adverts. They claim it’s an “accurate, science-based snapshot” of what’s happening inside your body. Finger-prick home tests assess liver enzymes, vitamin D and thyroid function.

Last year, however, Numan were censored by the Advertising Standards Authority for promising that their test was “free if we don’t find anything”. But as the ASA stated: “At least 90% of people who had used the Fear Nothing Blood Test had a result for at least one biomarker outside of the ‘normal’ range. We considered that this was a very high proportion of people whose test result indicated that they likely had something medically wrong with them. There was no information in the ad to inform consumers that false positives could occur or that their test results could be inaccurate.”

“From a statistical perspective,” explains David Spiegelhalter, emeritus professor of statistics at Cambridge University, “it is essentially inevitable that an apparently ‘positive’ result will be found if enough tests are done, just by chance alone. Investigating such a ‘false discovery’ can only lead to unnecessary anxiety and expense.” At the same time, ASA has also challenged Numan’s subscription model — claiming that people weren’t aware they were signing up to repeat tests.

As advocates of health screening always say, people have a right to obtain whatever information they wish about their own bodies. But companies selling these tests should tell the full story of their limitations. For not only do these firms fail to inform people adequately about what they’re signing up for, they also risk causing needless anxiety — and clog up the NHS when worried patients go to their doctors. This isn’t merely a hypothetical danger: one 2023 survey found that 90% of responding GPs had patients who visited them to discuss the results of private screening tests. The NHS is essentially left to pick up the pieces once the private sector has profited, leaving those who really do have valid concerns at the back of a lengthening queue.

Obviously, Neko Health claims this isn’t their model. They say, rather, that their aim is to alleviate strain on the NHS, suggesting that patients will see a doctor during their visit to the clinic. The physician is there to explain results, answer questions and arrange any further tests “at no extra cost” to either the patient or the NHS But, tellingly, Neko will then “refer you back to your GP with our findings and recommendations”.

As the NHS grapples with immense pressures, the likes of Neko Health and Numan purportedly step in to fill the gap. The result? Longer waiting times, diminished resources, and a growing sense of inequity in healthcare access. It’s a troubling paradox: as our public health system falters, the private sector thrives, and we all bear the brunt of its consequences.