I agree that there are serious problems with non-experts administering these systems at local levels as well. There's no good answer right now, IMHO, only less

I agree that there are serious problems with non-experts administering these systems at local levels as well. There's no good answer right now, IMHO, only less bad ones. But there is a huge difference between the two main policies here in the scale of damage that could be caused by a catastrophic failure. For the same reason, I have limited sympathy for the idea that this is just another internal data transfer and people are getting worked up without cause. The NHS isn't really a single organisation, the people pushing for this aren't really clinical staff, and there has been a long and undignified history of screw-ups when it comes to patient confidentiality and larger data sharing schemes. Caution does seem to be in order here.