Central NHS database
Surely a centralised database costing millions and being delayed is not the way forward?
If we have learnt nothing from the Internet surely its that you only have to design the protocol and then let others decide on the implementation? If the NHS decided it wanted electronic records it could have them within the year. Most doctors have software to manage their practices and print prescriptions. Now if the NHS defined a standard XML schema for exchanging data you would be sure all those companies supplying the doctors IT systems would be developing adding the feature to the software, who would want to be left behind and risk losing a customer?
Ah, but what about resilience I hear you say. Clearly that could be covered using P2P protocols. If the information exchange was over a standard P2P network, hospitals would become supernodes with community doctors just being the peers. You can buy off the shelf P2P cache systems that will ensure your data is available and at a speed. Sun has already given us a free P2P protocol http://www.jxta.org/ but it is by no means the only one.
Ah, but what about security I hear you say. Another no brainer really, as with the central database you will also need a security database to authorise people. LDAP is an industrial standard and any application developer worth their salt could authenticate against it, since Microsofts Active Directory is most likely already running in the NHS it would be another standard off the shelf component, of course there would be alternatives: OpenLdap, Novell eDirectory, Sun Java Directory System or Red hat Directory Server to name a few off the top of my head.