I would have thought that the fundamental reason for centralised medical
records is cost savings and better health care.

It isn't just about you personally.  It's the aggregate effects that a
government should be interested in, i.e. better value from health spending
(which if you haven't noticed is Big and Increasing.)  This has risks but
it also has clear benefits.  There's a lot of focus on risks but not a lot
on benefits (or outright denial that there are any benefits at all which is
to my mind about as sane as antivaxer stuff).  In general, the health
system is rife with silos of information that are unavailable to inform
individual or policy decisions.  There are enormous benefits from
evidence-based medicine and we certainly aren't there yet.

No one has "skin in the game" for the aggregate benefits, or at least not
directly.  Suppose, for example, the government billed anyone without a
MyHR record the full cost of unnecessary duplicate tests, would this change
attitudes.
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