@ no one
"the best solution to medical records is probably the patient carrying around their own health records on a USB stick or similar, suitably encrypted"
Yeah... because when someone's admitted to A&E at 1 o'clock on a Sunday morning (peak time for admissions due to pissheads falling over, bottling each other etc), they're really going to have the stick on them, thus allowing quick access to their medical history. And there's no chance at all that large numbers of patients will lose them, either.
</sarcasm>
Anyone who's ever been near a Medical Records department should be aware at how inefficient the current paper system is. Notes have to be physically transferred - often by taxi believe it or not, which costs ridiculous amounts - and aren't available when they're needed. This can mean the difference between life and death for a patient in need of fast and precise treatment.
You can criticise the implentation of IT projects within the NHS and you'd have a point but the case for needing an electronic patient record system is pretty much watertight in my opinion.
Doctors need the best possible information on new patients as quickly as possible - it's no longer realistic to rely on already knowing every patient and their entire family like back in the "good old days" because people move around more nowadays and doctors do too.
If a patient is out of the area covered by the Primary Care Trust they're registered with and is admitted urgently out of hours, a nationalised electronic records system is the only thing that will let clinicians act with full knowledge of the patient's medical history. What precise form that takes is of course a matter for debate.