In the long effort to catch cancer before it kills, medicine has always been tempted by the promise of a single, elegant answer. The NHS's £150 million trial of the Galleri blood test — meant to detect more than fifty cancers at once — now faces a reckoning: a BMJ investigation suggests the trial may be more shaped by commercial enthusiasm than scientific rigor, and that the people entrusted to evaluate the evidence may have been too close to those selling it. The delay of interim results and the quiet concerns of the UK's own screening advisors suggest that when hope and money move together,
BMJ investigation challenges NHS Galleri cancer blood test amid ethical concerns
The clinical data doesn't stack up, but that should have come first.
Mark
So the NHS is spending £150 million on a test that doesn't actually work yet?
Mimi
Not quite. They're spending £150 million to find out if it works. The problem is that the trial itself may not be designed in a way that can actually answer that question.
Luke
What do you mean by that? What's wrong with the trial design?
Mimi
The BMJ investigation found leaked documents suggesting the trial can't justify a national screening program. Experts say it's unethical. But the specifics of what makes it unsuitable aren't fully spelled out in the reporting.
Mark
And the interim results came back and they were... not good?
Mimi
Not compelling enough, according to NHS England. They were supposed to come out this month. Instead, the decision got pushed to 2026.
Luke
That's interesting though—if the interim results were truly terrible, wouldn't they say that? "Not compelling enough" is different from "this doesn't work."
Mimi
Right. It's a softer language. But it's also a delay. If you had strong evidence, you'd probably move faster.
Mark
What about the government connections? That seems like a separate problem.
Mimi
There are meetings between Grail executives and Lord Cameron and Nadhim Zahawi. Freedom of Information requests turned those up. And an anonymous NHS source said the data doesn't stack up but nobody asked about that first.
Luke
But we don't know what was discussed in those meetings. We know they happened. We don't know if they influenced the trial.
Mimi
True. But the chair of the National Screening Committee privately told NHS England's chief executive he had serious concerns. That's documented in emails. So there was internal doubt.
Mark
And Grail is being sued in the US?
Mimi
Yes. Investors claim the company exaggerated how well the test works to pump up the stock price.
Luke
That's a separate legal matter though. It doesn't necessarily mean Galleri doesn't work. It means investors think they were misled about its effectiveness.
Mimi
Fair point. But it adds to the picture of a company that may have oversold what it has.
Mark
So what happens now?
Mimi
The trial continues until 2026. The new Health Secretary, Wes Streeting, has said he wants the UK to be a medical technology powerhouse. Experts are saying he needs to set up more rigorous oversight of how these decisions get made.
The Pulse
- A £150 million public investment in a cancer blood test is now under scrutiny after interim results failed to meet the bar needed to justify a national rollout, pushing any decision to 2026.
- A BMJ investigation reveals leaked documents and emails showing that senior government figures met privately with Grail executives, and that the chair of the UK's own screening advisory body raised 'serious concerns' that were never acted upon.
- Experts are calling the trial unethical and poorly designed, warning that the test has been systematically oversold — a charge echoed by a US class action lawsuit alleging Grail inflated its stock price by exaggerating Galleri's effectiveness.
- NHS England insists the trial is among the most rigorous ever conducted, but critics say the structure of the deal — including a promised UK manufacturing facility — suggests commercial incentives may have outweighed scientific ones.
- Researchers and policy voices are now urging the new Health Secretary to impose stricter, more transparent oversight before public health infrastructure is again tied to unproven medical technology.
In the long effort to catch cancer before it kills, medicine has always been tempted by the promise of a single, elegant answer. The NHS's £150 million trial of the Galleri blood test — meant to detect more than fifty cancers at once — now faces a reckoning: a BMJ investigation suggests the trial may be more shaped by commercial enthusiasm than scientific rigor, and that the people entrusted to evaluate the evidence may have been too close to those selling it. The delay of interim results and the quiet concerns of the UK's own screening advisors suggest that when hope and money move together, the truth can be the last thing to arrive.
The NHS is spending £150 million to trial Galleri, a blood test made by California biotech company Grail that claims to detect more than fifty types of cancer. More than 100,000 people in England are enrolled. If the trial succeeds, the NHS has agreed to purchase millions of tests and fund a UK manufacturing facility — a deal that, at $950 per test in the United States, represents an enormous commercial prize.
But a BMJ investigation led by Dr Margaret McCartney and journalist Deborah Cohen has raised serious doubts about whether the trial was ever designed to answer the question it was meant to answer. Leaked documents suggest the trial cannot justify a national screening rollout, and experts quoted in the piece describe the test as oversold and the trial itself as unethical. The interim results, expected this month, were quietly shelved — NHS England saying they were not 'compelling enough' to proceed, with any final decision now deferred to 2026.
The investigation also exposed the proximity between Grail and senior UK government figures. Freedom of Information requests revealed meetings between Grail executives and former Prime Minister Lord Cameron and then-minister Nadhim Zahawi. More striking still, emails reviewed by The BMJ show that the chair of the UK National Screening Committee privately told NHS England's chief executive he had 'serious concerns' about the trial — yet it continued regardless.
Grail is simultaneously facing a US class action lawsuit in which investors allege the company exaggerated Galleri's effectiveness to inflate its stock price. Richard Sullivan of King's College London called the situation 'a clear-cut case of public risk and private profit,' and warned that the new government must build more rigorous frameworks for evaluating medical technology before committing NHS resources at this scale. 'It's all promissory science and hype,' he said. 'This serves no public good whatsoever.'
NHS England maintains the trial is among the most thorough ever conducted in any healthcare system. But the deeper question the investigation leaves open is whether the lure of a lucrative contract and a new domestic facility quietly tilted the judgment of those who were supposed to be weighing the science.
The NHS is spending £150 million to test a blood test called Galleri that its maker, a California biotech company called Grail, says can detect more than fifty types of cancer. The trial involves more than 100,000 people in England. If it works, the NHS has agreed to buy millions of tests and fund a new manufacturing facility in the UK. A single test costs $950 in the United States.
But The BMJ published an investigation this week that raises serious questions about whether the trial is even designed properly to answer the question it's supposed to answer. The investigation, led by Dr Margaret McCartney and investigative journalist Deborah Cohen, found leaked documents suggesting the trial cannot justify rolling out Galleri as a national screening program. Experts quoted in the reporting say the test has been oversold and the trial itself is unethical.
The interim results were supposed to come out this month. They didn't. Instead, NHS England said the results were not "compelling enough" to move forward, pushing any decision about national rollout to 2026. That delay itself is telling. Grail has marketed Galleri as a breakthrough that could catch difficult-to-diagnose cancers like those of the head, neck, ovaries, and pancreas early enough to save lives. The company's own founder has called it "ground-breaking and potentially life-saving." But the data so far has not supported that promise.
The investigation also uncovered something else: the closeness between Grail and senior UK government figures. Freedom of Information requests obtained by The BMJ show meetings between Grail executives and former Prime Minister Lord Cameron and Nadhim Zahawi, who was then a minister in the Department for Business, Energy and Industrial Strategy. An anonymous NHS England source told The BMJ that "the clinical or scientific data doesn't stack up, but that should have come first. This is not the way to do a trial—it should be done transparently. It's not been thought through at all."
Even the chair of the UK National Screening Committee, the body that advises on which tests should be offered to the public, privately told NHS England's chief executive that he had "serious concerns" about the trial, according to emails The BMJ reviewed. Yet the trial has continued.
Grail is also facing a class action lawsuit in the United States. Investors who lost money claim the company exaggerated how well Galleri works in order to inflate its stock price. Richard Sullivan, director of the Institute of Cancer Policy at King's College London, described the situation as "a clear-cut case of public risk and private profit." He told The BMJ that the new government needs to establish more rigorous and transparent ways of reviewing medical technology research, especially when it involves such widespread access to NHS resources. "It's all promissory science and hype," he said. "This serves no public good whatsoever."
An NHS England spokesperson responded by saying that Grail is "now being subjected to one of the largest and most rigorous investigations done in any health-care system worldwide," and that no decision has been made about rolling out the test. But the investigation raises a question about how decisions get made in the first place—and whether the promise of a lucrative deal and a new facility in the UK shaped the judgment of the people who were supposed to be evaluating the science.
Notable Quotes
The clinical or scientific data doesn't stack up, but that should have come first. This is not the way to do a trial—it should be done transparently.— Anonymous NHS England source
A clear-cut case of public risk and private profit.— Richard Sullivan, director of the Institute of Cancer Policy, King's College London
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