Now, keeping in mind the political such and such, this begs a question whether the economics of scale would better catch off via a larger NHSDT+EHDS and not via

Now, keeping in mind the political such and such, this begs a question whether the economics of scale would better catch off via a larger NHSDT+EHDS and not via the usual players? In any case, opt-out is a minimum requirement insofar as citizens go.