Why can't I just go to a website, stick in my NHS number, click a button, and have that registed on an 'opt out' database? Then before the extract, filter every patient that's done this?
Why the fuck do I have to download a paper form, print it out, fill it in, sign it, post it or hand deliver it to my GP who then has to open it, go to their computer, log in, find my patient record, and apply some opt out code?
Because god knows GPs don't have enough work to be doing right now. The cumulative time spent collectively dealing with hundreds of thousands of pieces of paperwork is exactly what they want.