The neurological and wider clinical domains stand to gain greatly from the vision of the Grid in providing seamless yet secure access to distributed, heterogeneous computational resources and data sets. Whilst a wealth of clinical data exists within local, regional and national healthcare boundaries, access to and usage of these data sets demands that fine grained security is supported and subsequently enforced. This paper explores the security challenges of the e-Health domain, focusing in particular on authorization. The context of these explorations is the MRC funded VOTES (Virtual Organisations for Trials and Epidemiological Studies) and the JISC funded GLASS (Glasgow early adoption of Shibboleth project) which are developing Grid infrastructures for clinical trials with case studies in the brain trauma domain.