Patients are to be given the chance to opt out of having medical information stored on the new NHS IT database.
Patients are to be allowed to opt out of the electronic database
The database, which is being installed as part of the NHS's IT upgrade, allows staff to access records wherever someone is treated.
But patients will have the choice of having no records kept about them at all, or restricting access to the most sensitive information.
The government has rejected concerns the database will not be secure.
It also said patient confidentiality would not be compromised by the database.
Health Minister John Hutton said patients would have the right not to have their medical records stored electronically at all.
A second option of sealing the most sensitive data in an "electronic envelope" for use only in emergencies is also being offered.
However, Mr Hutton said: "I believe very few people will opt out of the records.
"I hope and believe that patients will want to be part of this because it will help to save people's lives."
And Richard Granger, director general for NHS IT, said the scheme was more secure than the old paper records system.
"The system will log every person who accesses a patient's information.
"Currently there is no record of who has accessed what so it is very difficult to control who picks notes up."
Mr Granger also said there was a danger details could be lost under the current system.
"Paper is pretty dangerous for patients. It gets lost, can lead to prescription errors and so on."
Under the IT upgrade, which Computer Weekly magazine warned last year could cost up to £31bn, patients will also be able to book hospital appointments online at GP surgeries.
But it is the electronic database which is causing most controversy as critics believe it could lead to confidential medical records being accessed unnecessarily.
A spokesman for the British Medical Association said: "Confidentiality is central to the doctor-patient relationship and so it is paramount that the systems used to construct the electronic records are secure.
"Only authorised staff should have the ability to access records and make amendments as changes to a patient's notes can have a serious impact on their health.
"Systems should also provide a secure audit trail that accurately records who has accessed or made amendments to patient records."