One can describe the essence of the privacy problem brought about by the previous government's strategy as follows. The likelihood that unauthorised use will be made of information is a function of its value and the number of people who have access to it; and consolidating valuable private information, such as medical records, into large databases increases both of these risk factors simultaneously. We can live with the occasional disclosures that result from abuse of record access by general practice staff, but we could not accept a situation in which the staff of all 36,000 general practices had access to the records of all 56,000,000 patients in Britain. Yet it is precisely this broad access to huge databases that is being deliberately engineered in many NHS systems.
Centralising data also brings safety problems in its wake, both directly and indirectly. Large centralised systems may fail less often, but when they do break down the results can be much more serious. For example, it is proposed to use an NHS-wide network to book hospital appointments. If this were to be implemented, and the network were to fail, we could lose the whole machinery of hospital waiting lists.