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Home / Publications / For Your Information: Australian Privacy Law and Practice (ALRC Report 108) / 63. Privacy (Health Information) Regulations / Access to health information
For Your Information: Australian Privacy Law and Practice (ALRC Report 108)
Part A—Introduction
Part B—Developing Technology
Part C—Interaction, Inconsistency and Fragmentation
Part D—The Privacy Principles
Part E—Exemptions
Part F—Office of the Privacy Commissioner
Part G—Credit Reporting Provisions
Part H—Health Services and Research
Part I—Children, Young People and Adults Requiring Assistance
Part J—Telecommunications
Part K—Protection of a Right to Personal Privacy
Model Unified Privacy Principles (UPPs)
UPP 1. Anonymity and Pseudonymity
UPP 2. Collection
UPP 3. Notification
UPP 4. Openness
UPP 5. Use and Disclosure
UPP 6. Direct Marketing (only applicable to organisations)
UPP 7. Data Quality
UPP 8. Data Security
UPP 9. Access and Correction
UPP 10. Identifiers (only applicable to organisations)
UPP 11. Cross-border Data Flows
Introduction to the ALRC's Privacy Inquiry
Extensive public engagement
1. Introduction to the Inquiry
The scope of the Inquiry
Related privacy inquiries
The meaning of privacy
Information privacy: the commercial context
Process of reform
Organisation of this Report
Further processes
2. Privacy Regulation in Australia
Federal regulation of privacy
State and territory regulation of privacy
Other forms of privacy regulation
3. Achieving National Consistency
The federal system
Is national consistency important?
National legislation to regulate the private sector
An intergovernmental agreement
Other methods to achieve national consistency
4. Regulating Privacy
Regulatory theory
ALRC's preference for principles-based regulation
ALRC's preference for compliance-oriented regulation
Scope for co-regulation
5. The Privacy Act: Name, Structure and Objects
Overview of the Privacy Act
The structure of the Act
The name of the Act
The objects of the Act
6. The Privacy Act: Some Important Definitions
What is 'personal information'?
What is not 'personal information'?
Generally available publications
7. Privacy Beyond the Individual
Privacy and group rights generally
Extension of the Privacy Act to groups?
Traditional laws and customs of Indigenous groups
Privacy protocols for Indigenous groups
Corporations and commercial entities
8. Privacy of Deceased Individuals
Discussion Paper proposals
9. Overview: Impact of Developing Technology on Privacy
Privacy-enhancing technologies
Radio frequency identification
Other wireless technologies
Data-matching and data-mining
Biometric systems
DNA-based technologies
Voice over Internet Protocol
Location detection technologies
Surveillance technologies
Other developing technologies
10. Accommodating Developing Technology in a Regulatory Framework
Should the Privacy Act be technology neutral?
Key themes in a 'technology aware' framework
Oversight powers of the OPC
Technology-specific guidance on the application of the model UPPs
Mandating standards?
Co-regulation between the OPC and industry
Technology-related amendments to the Privacy Act
11. Individuals, the Internet and Generally Available Publications
Individuals acting in a personal capacity
12. Identity Theft
How prevalent is it?
Criminalising identity theft
Other responses to identity theft
Identity theft and privacy laws
13. Overview: Interaction, Inconsistency and Fragmentation
The costs of inconsistency and fragmentation
Federal information laws
Required or authorised by or under law
Interaction with state and territory laws
14. The Costs of Inconsistency and Fragmentation
Compliance burden and cost
Multiple regulators
15. Federal Information Laws
Freedom of Information Act 1982 (Cth)
Access, correction and annotation
Archives Act 1983 (Cth)
A single information Act?
A single regulator?
Secrecy provisions
Obligations of confidence
16. Required or Authorised by or Under Law
'Required or authorised by or under law'
Census and Statistics Act 1905 (Cth)
Corporations Act 2001 (Cth)
Commonwealth Electoral Act 1918 (Cth)
Anti-Money Laundering and Counter-Terrorism Financing Act 2006 (Cth)
17. Interaction with State and Territory Laws
Interaction of federal, state and territory regimes
Intergovernmental bodies
State and territory regulators
Privacy rules, codes and guidelines
Residential tenancy databases
18. Structural Reform of the Privacy Principles
Introduction to Part D
Development of current Australian privacy principles
Principles-based regulation
Level of detail, guidance and protection
Towards a single set of privacy principles
Application of the Unified Privacy Principles
Scope and structure of Unified Privacy Principles
A separate privacy principle dealing with consent?
20. Anonymity and Pseudonymity
Expanding the anonymity principle
Application of the 'Anonymity and Pseudonymity' principle
Guidance on the 'Anonymity and Pseudonymity' principle
Summary of 'Anonymity and Pseudonymity' principle
Current coverage by IPPs and NPPs
Collection from the individual
Unsolicited personal information
Other aspects of the 'Collection' principle
Summary of 'Collection' principle
22. Sensitive Information
Collection of sensitive information
Regulation of other aspects of handling sensitive information
23. Notification
Location of notification requirements: separate principle?
Nature and timing of notification obligation
Circumstances in which notification obligations arise
Subject matter of notification
Summary of 'Notification' principle
24. Openness
A separate 'Openness' principle
Regulatory mechanism: 'Privacy Policies'
Content of a Privacy Policy
Availability of Privacy Policy
Short form privacy notices
Summary of 'Openness' principle
25. Use and Disclosure
A single 'Use and Disclosure' principle
Circumstances in which use and disclosure is permitted
Additional exceptions?
Logging use and disclosure
Summary of 'Use and Disclosure' principle
Application of direct marketing principle to agencies
Relationship between privacy principles and other legislation
Content of the 'Direct Marketing' principle
Direct marketing to vulnerable individuals
Other OPC guidance
Summary of 'Direct Marketing' principle
27. Data Quality
Application of the 'Data Quality' principle to agencies
Scope of the 'Data Quality' principle
Balancing data quality and other privacy interests
Summary of 'Data Quality' principle
28. Data Security
Towards a single data security principle
Prevention of misuse and loss of personal information
Information destruction and retention requirements
Summary of 'Data Security' principle
29. Access and Correction
The 'Access and Correction' principle
Access to personal information: general framework
Access to personal information: exceptions
Access to personal information: intermediaries
Correction of personal information
Annotation of disputed information
Procedural requirements for access and correction requests
Guidance on the 'Access and Correction' principle
Summary of 'Access and Correction' principle
30. Identifiers
Is there a need for an 'Identifiers' principle?
Application of 'Identifiers' principle to agencies?
Definition of 'identifier'
Content of privacy principle dealing with identifiers
Multi-purpose identifiers
Regulation of Tax File Numbers
Summary of 'Identifiers' principle
31. Cross-border Data Flows
International privacy protection
Current coverage of cross-border data flows
Content of the model 'Cross-border Data Flows' principle
Interaction with the 'Use and Disclosure' principle
Definition of 'transfer'
Related bodies corporate
List of overseas jurisdictions
Cross-border enforcement
OPC Guidance
Requirement of notice that personal information is being sent overseas
Summary of 'Cross-border Data Flows' principle
32. Additional Privacy Principles
'Accountability' principle
'Prevention of Harm' principle
'No Disadvantage' principle
33. Overview: Exemptions from the Privacy Act
Privacy Act exemptions
Exemptions under international instruments
Should there be any exemptions from the Privacy Act?
The number and scope of exemptions
Complexity of the exemption provisions
Location of the exemption provisions
34. Intelligence and Defence Intelligence Agencies
The defence and defence intelligence agencies
Rationale for the exemption of the intelligence and defence intelligence agencies
Inspector-General of Intelligence and Security
35. Federal Courts and Tribunals
Federal tribunals
Access to court and tribunal records
36. Exempt Agencies under the Freedom of Information Act
Australian Fair Pay Commission
Schedule 2, Part I, Division 1 of the FOI Act
Schedule 2, Part II, Division 1 of the FOI Act
ALRC's view
37. Agencies with Law Enforcement Functions
Australian Crime Commission
Other agencies with law enforcement functions
38. Other Public Sector Exemptions
Commissions of inquiry
State and territory authorities
Prescribed state and territory instrumentalities
State and territory government business enterprises
Opt-in provision
Should state and territory authorities be exempt from the operation of the Act?
39. Small Business Exemption
Discussion Paper proposal
Arguments for removing the exemption
Arguments for retaining the exemption
Compliance costs
Minimising costs of compliance on small businesses
40. Employee Records Exemption
Evaluative material
Location of privacy provisions concerning employee records
41. Political Exemption
Exemption for registered political parties, political acts and practices
Guidance on applying the Privacy Act to the political process
42. Journalism Exemption
Retaining an exemption for journalistic acts and practices
Scope of the journalism exemption
Media privacy standards
43. Other Private Sector Exemptions
Personal or non-business use
Change in partnership
44. New Exemptions or Exceptions
Alternative dispute resolution bodies
Establishing, pursuing and defending legal rights
Archivists and archival organisations
Declared emergencies
45. Overview: Office of the Privacy Commissioner
Facilitating compliance with the Privacy Act
Structure of the OPC
Powers of the OPC
Privacy codes
Investigation and resolution of privacy complaints
Enforcing the Privacy Act
Summary of recommendations to address systemic issues
46. Structure of the Office of the Privacy Commissioner
Structure, functions and powers
Manner of exercise of powers
Privacy Advisory Committee
Expert panels
47. Powers of the Office of the Privacy Commissioner
Oversight powers
Personal Information Digest
Compliance powers
Audit functions
Self-auditing
Functions under other Acts
Public interest determinations
48. Privacy Codes
Part IIIAA Privacy codes
Binding codes
49. Investigation and Resolution of Privacy Complaints
Investigating privacy complaints
Transferring complaints to other bodies
Resolution of privacy complaints
Other issues in the complaint-handling process
50. Enforcing the Privacy Act
Enforcing 'own motion' investigations
Enforcing determinations
Reports by the Commissioner
Other enforcement mechanisms following non-compliance
Rationale for data breach notification
Models of data breach notification laws
52. Overview: Credit Reporting
What is credit reporting?
Credit reporting agencies
Background to national regulation
53. Credit Reporting Provisions
Application of the credit reporting provisions
Content of credit information files
Accuracy and security of personal information
Consent and credit reporting
Rights of access, correction and notification
Responsibilities and powers of the OPC
Remedies and penalties
54. Approach to Reform
Part IIIA and the NPPs
Repeal and new regulation under the Act
Application of the regulations
Credit reporting information
Credit providers
Application to foreign credit providers
Consumer and commercial credit
Review of the regulations
Credit reporting code
55. More Comprehensive Credit Reporting
'Positive' or 'more comprehensive' credit reporting?
Australia's approach to more comprehensive credit reporting
Regulation in other jurisdictions
The argument for more comprehensive credit reporting
Benefits of more comprehensive credit reporting
Problems with more comprehensive credit reporting
Models of more comprehensive credit reporting
Other aspects of the model
56. Collection and Permitted Content of Credit Reporting Information
Collection and notification
Permitted content of credit reporting information
Identifying information
Inquiry information
'Negative' information
Prohibited content of credit reporting information
Debts of children and young people
Notification of collection
57. Use and Disclosure of Credit Reporting Information
Use and disclosure
Use and disclosure of credit reporting information
Mortgage and trade insurers
'Pre-screening'
Disclosure of reports relating to credit worthiness
58. Data Quality and Security
Data quality and credit reporting information
Regulating data quality
Data quality issues
Data quality obligations of credit reporting agencies
Auditing credit reporting information
Deletion of credit reporting information
59. Access and Correction, Complaint Handling and Penalties
Access and correction obligations
Access and correction in practice
Notification of adverse credit reports
Information about credit scoring processes
External dispute resolution
Time limits on disputed credit reporting information
Investigation and resolution of credit reporting complaints
60. Regulatory Framework for Health Information
National consistency
A separate set of Health Privacy Principles?
61. Electronic Health Information Systems
Medicare and Pharmaceutical Benefits databases
62. The Privacy Act and Health Information
Definition of 'health information'
Definition of 'health service'
Agencies and organisations
Provision of health services
63. Privacy (Health Information) Regulations
Collection of health information
Use and disclosure of health information
Access to health information
Management, funding and monitoring of health services
64. Research: Current Arrangements
Health and medical research in Australia
Research and the use of personal information
Information Privacy Principles
National Privacy Principles
Section 95 and 95A Guidelines
65. Research: Recommendations for Reform
Research in areas other than health and medical
Definition of research
The public interest balance
Impracticable to seek consent
Human Research Ethics Committees
Research exceptions to the model Unified Privacy Principles
66. Research: Databases and Data Linkage
Establishing databases
Using and linking information in databases
67. Children, Young People and Attitudes to Privacy
Generational differences in attitudes to privacy
Attitudes of young people to privacy
ALRC consultations with young people
68. Decision Making by and for Individuals Under the Age of 18
Privacy rights of children and young people at international law
Existing Australian laws relating to privacy of individuals under the age of 18
Research on capacity
Capacity and health information
Possible models for assessing capacity
69. Particular Privacy Issues Affecting Children and Young People
Online consumers and direct marketing issues
Identification in criminal matters and in court records
Child welfare and juvenile justice
Taking photographs and other images
70. Third Party Representatives
Third party decision making under the Privacy Act
Problems with the Privacy Act
Adults with a temporary or permanent incapacity
Third party representatives acting with consent
Implementing third party arrangements
71. Telecommunications Act
Telecommunications Act 1997 (Cth)
Interaction between the Privacy Act and the Telecommunications Act
Are two privacy regimes necessary?
A redraft of the Part
A review of telecommunications regulation
Does the Telecommunications Act provide adequate privacy protection?
Criminal or civil penalties?
Telecommunications regulators
72. Exceptions to the Use and Disclosure Offences
Exceptions to the use and disclosure offences
Performance of person's duties
Threat to person's life or health
Knowledge of person concerned
Implicit consent
Business needs of other carriers or service providers
Specially protected information
Credit reporting information and credit worthiness
The regulation of public number directories
Integrated public number database
Public number directories not sourced from the IPND
Are public number directories desirable?
Charging a fee for an unlisted number
73. Other Telecommunications Privacy Issues
Interception and access
Telecommunications (Interception and Access) Act
Interaction with the Privacy Act
Communications and 'telecommunications data'
Retention and destruction of records
Spam and telemarketing
Should the Privacy Act regulate spam and telemarketing?
Spam Act
Do Not Call Register Act
74. Protecting a Right to Personal Privacy
Right to personal privacy—developments in Australia and elsewhere
NSWLRC Consultation Paper on invasion of privacy
Recognising an action for breach of privacy in Australia
63.107 In Breen v Williams,[98] the High Court of Australia unanimously held that health consumers do not have a right of access to their medical records as a matter of common law. Consequently, health consumers must rely on legislation, including the Privacy Act, to provide them with a right of access to the health information held in medical records.
63.108 IPP 6 provides in relation to agencies that:
Where a record-keeper has possession or control of a record that contains personal information, the individual concerned shall be entitled to have access to that record, except to the extent that the record-keeper is required or authorised to refuse to provide the individual with access to that record under the applicable provisions of any law of the Commonwealth that provides for access by persons to documents.
63.109 The exceptions to IPP 6 include, for example, those situations in which a record-keeper is required or authorised to refuse access under the Freedom of Information Act 1982 (Cth) (the FOI Act) and the Archives Act 1983 (Cth). Chapter 15 considers how this legislation, including the exemptions set out in the legislation, interacts with the Privacy Act.
63.110 NPP 6 provides that organisations must provide individuals with access to their personal information on request, subject to a number of exceptions. In the case of health information, organisations are not required to provide access if doing so would pose a serious threat to the life or health of any individual.[99] The list of exceptions also includes situations in which: providing access would have an unreasonable impact on the privacy of other individuals;[100] the information relates to existing or anticipated legal proceedings between the organisation and the individual, and the information would not be accessible by the process of discovery;[101] and denying access is required or authorised by or under law.[102]
63.111 The draft National Health Privacy Code provides very detailed provisions on providing access to health information and for dealing with situations in which access is refused. As discussed in Chapter 60, this level of detail should not be included in a principles-based regime, but could be included in guidelines as suggested best practice. The grounds provided in NHPP 6 for refusing access are essentially the same as those provided in NPP 6.[103]
63.112 Both health consumers and health service providers appear to have concerns relating to access to health information. Of the 330 complaints under the NPPs against health care providers received by the OPC between 21 December 2001 and 31 January 2005, roughly half (163) concerned a refusal of access to health records.[104]
Breakdown in therapeutic relationship
63.113 In the course of the OPC Review, the AMA and the Mental Health Privacy Coalition expressed concern that, in the health care context, there are occasions when providing access to medical records could cause harm to the health consumer or interfere with the therapeutic relationship between a health consumer and a health service provider.[105] The OPC Review stated that access issues can cause breakdowns in therapeutic relationships and that this may give rise to a serious risk to patient health.[106]
63.114 The OPC expressed the view that NPP 6.1(c)—which allows an organisation to deny access where it would have an unreasonable impact on the privacy of someone else—might be relied upon to protect health service providers' views in some circumstances. The OPC did not address the situation in which providing access might cause a breakdown in the therapeutic relationship, but would not pose a serious threat to the life or health of an individual. The OPC did not recommend an amendment to NPP 6,[107] but has issued further guidance in an information sheet on this matter: Denial of Access to Health Information due to a Serious Threat to Life or Health.[108]
63.115 In IP 31, the ALRC asked whether the exception in NPP 6.1(b)—that allows access to be denied if it would pose a serious threat to the life or health of any person—was appropriate. The ALRC asked whether the exception should be extended to allow a health service provider to deny access to health information if providing access would pose a threat to the therapeutic relationship between the health service provider and the health consumer.[109]
63.116 There was strong support among stakeholders for the existing exception in NPP 6.1(b)[110] and little support for extending the exception to include threats to the therapeutic relationship alone. A number of submissions noted that, while denying access to health information can damage therapeutic relationships, health consumers are at liberty to change health service providers if the relationship does break down. The ANF was strongly of the view that:
This exception should NOT be extended to allow a health service provider to deny access to health information if providing access to the information would pose a threat to the therapeutic relationship between the health service provider and the health consumer. If the therapeutic relationship is so fragile then it is not going to be improved if the health service provider refuses to provide access. There is also the potential for a person to deny access for an improper purpose eg the information reveals an adverse event, inappropriate care or treatment or other information that a person may be entitled to have.[111]
63.117 The OPC stated that NPP 6.1(b) is an appropriate and effective exception, and should not be extended to include threats to the therapeutic relationship alone.
The fact that the threat must be 'serious' reflects the principle that access to one's own personal information should be the rule, rather than the exception. At the same time the exception is broad enough to encompass serious threats to any relevant person (including threats to mental health), such as the individual themselves, other patients, practitioners and staff, and the individual's family. Similar language is used in the equivalent exceptions under NSW and Victorian health records legislation.[112]
63.118 The OPC suggested, however, that the phrase 'would pose a serious threat' in NPP 6.1(b), requires a degree of certainty that may not always be achievable in clinical environments. It is not always possible to predict how a health consumer will react to being granted access to their health information. On this basis, the OPC suggested an alternative test of 'reasonably likely to pose a serious threat to the life or health of any individual'.
63.119 There was little support for extending the exception in NPP 6.1(b) to include a threat to the therapeutic relationship, and the ALRC view is that there is no case to recommend this change.
63.120 The ALRC agrees with the OPC that the current test—'providing access would pose a serious threat to the life or health of any individual'—requires a level of certainty that may be very difficult to establish. The 'Access and Correction' principle, discussed in detail in Chapter 29, has adopted the approach suggested by the OPC. The principle provides in part that, if an individual requests access to personal information, an agency or organisation must respond within a reasonable time and provide the individual with access to the information except to the extent that:
in the case of an agency, the agency is required or authorised to refuse to provide the individual with access under the applicable provisions of any law of the Commonwealth that provides for access by persons to documents. Under this exception, agencies may deny an individual access on the basis of exceptions set out in the FOI Act. The FOI Act provides that access may be denied where disclosure 'would, or could reasonably be expected to endanger the life or physical safety of any person';[113] and
in the case of an organisation, providing access would be reasonably likely to pose a serious threat to the life or health of any individual.[114]
Use of intermediaries
63.121 The IPPs do not provide expressly for the use of intermediaries to resolve situations in which access to information is denied by an agency under the Privacy Act. A consumer denied access to health information, however, could lodge a complaint with the Privacy Commissioner under s 36 of theAct. The FOI Act provides that where an agency denies a request for access to a document containing personal information provided by a 'qualified person', on the basis that disclosure of the information might be detrimental to the applicant's physical or mental health or wellbeing, the agency may provide the document to a 'qualified person' nominated by the applicant.[115]
63.122 In relation to organisations, NPP 6.3 sets out a process involving the use of intermediaries to assist in situations in which access is denied.
If the organisation is not required to provide the individual with access to the information because of one or more of paragraphs 6.1(a) to (k) (inclusive), the organisation must, if reasonable, consider whether the use of mutually agreed intermediaries would allow sufficient access to meet the needs of both parties.
63.123 The OPC Review noted that this mechanism is very limited.[116] Organisations are only required to consider whether the use of an intermediary would meet the needs of the parties but are not required to take any further action.
63.124 There is a more stringent right to the use of an intermediary in the draft National Health Privacy Code where access to health information is refused on the ground that providing access would pose a serious threat to the life or health of the individual. A health service provider may offer to discuss information with the consumer, or nominate a suitably qualified health service provider to discuss the information with the individual. If this does not occur, or the health consumer is not satisfied with the process, the health consumer may nominate a health service provider to act as intermediary.
63.125 Once an intermediary has been appointed, the health service provider must provide the intermediary with the individual's health information. The intermediary may then consider, among other things, the validity of the refusal to grant access and, if he or she thinks it appropriate to do so, discuss the content of the health information with the individual.[117]
63.126 In IP 31, the ALRC asked whether the provisions of the draft National Health Privacy Code established a more appropriate and effective framework for providing access to health information than the Privacy Act.[118]
63.127 The ANF expressed the view that:
There remains significant resistance across the health system in granting access to health consumers to their personal health information that will require major culture change. Whether it is in relation to fear of revealing litigable conduct or health professional censure; or is part of the characteristic paternalism that is linked to benevolence that has been a feature of the provision of health services over many years, is neither here nor there. It does, however indicate that there needs to be significant efforts made to inform and actively assist that culture to change.[119]
63.128 Although the OPC was generally of the view that the provisions in the draft National Health Privacy Code dealing with access to health information were overly complex and prescriptive, the Office did express support for stronger provisions around the use of intermediaries to assist with access to health information.[120]
63.129 The NHMRC also expressed support for amending the Privacy Act to provide a more explicit right to the use of an intermediary.[121]
63.130 In DP 72, the ALRC proposed that the 'Access and Correction' principle should provide stronger provisions on the use of intermediaries than the existing provisions in NPP 6.3. The proposed principle required organisations to take reasonable steps to reach a compromise involving the use of a mutually agreed intermediary, rather than simply requiring the organisation to consider the use of a mutually agreed intermediary.[122] The ALRC proposed that the OPC should provide guidance about what would amount to 'reasonable steps' in this context.[123] The ALRC also expressed the preliminary view that this provision would be useful in the context of providing access to personal information held by agencies, and, should apply to agencies.[124]
63.131 In addition, in relation to health information, the ALRC proposed more stringent requirements for the use of intermediaries in certain circumstances. The ALRC noted that almost half of the complaints lodged with the OPC against health service providers were in relation to access to health information, and that there appeared to be some resistance among health service providers to allowing health consumers access to their health information. In the ALRC's view, this situation would improve if health service providers were required to refer the requested health information to a registered medical practitioner for a second opinion in relation to the question of access.
63.132 The proposed provisions—to be included in the new Privacy (Health Information) Regulations—stated that where an organisation denied an individual access to his or her own health information on the ground that providing access would be reasonably likely to pose a serious threat to the life or health of any individual, the organisation was required to advise the individual that he or she could nominate a registered medical practitioner to be given access to the health information. Once the individual had nominated a registered medical practitioner, the organisation would be required to provide the medical practitioner with access to the individual's health information. The medical practitioner would then assess the grounds for denying access to the health information and could provide the individual with access to the information if he or she was satisfied that to do so would not be likely to pose a serious threat to the life or health of any individual.[125]
63.133 The proposed regulation did not require that the nominated medical practitioner be mutually agreed upon. The ALRC asked whether an organisation should have the opportunity to object to the individual's choice of nominated medical practitioner before providing access to the individual's health information.[126]
63.134 A number of stakeholders supported the proposed intermediary provisions.[127] The Victorian Office of the Health Services Commissioner expressed support for the provisions, but suggested that any such intermediary should be 'a suitably qualified health service provider', rather than a 'registered medical practitioner'.[128] The NHMRC also suggested that the intermediary might need to be a health care professional other than a medical practitioner.[129] The OPC was of the view that:
In some circumstances, an appropriate intermediary might be a person that is not registered by a medical board, but who has sufficient clinical knowledge of a condition, as well as the individual's circumstances, to adequately and appropriately serve in that role. For example, a counsellor in a support group for a specific condition might be a suitable intermediary.[130]
63.135 The OPC stated that the Office could develop guidance on what amounted to a suitable intermediary.[131] The Victorian Office of the Health Services Commissioner also suggested that the health service provider be required to provide the intermediary with the health information within a set period—suggesting 14 days would be appropriate—and that there was a need to address the question of fees.[132] Medicare Australia suggested that there should be an avenue of review available where there were concerns about the assessment made by the nominated medical practitioner.[133]
63.136 A number of stakeholders stated that the nominated medical practitioner should be mutually agreed upon and, in the event of a disagreement, that the Privacy Commissioner or another body should be given power to nominate an intermediary.[134] Avant Mutual Group Ltd stated that a provision along these lines was necessary to ensure that a medical practitioner with appropriate expertise was involved as an intermediary.[135] The OPC suggested that:
If a provider did not reasonably believe that a nominated intermediary was appropriate in the circumstances, then it could refuse to provide access through the intermediary mechanism. In such a case, the individual could nominate an alternative intermediary, or have the option to complain to the Office. In assessing such a complaint, the Office would ask the provider to provide its reasons as to why the nominated intermediary was not appropriate. The Office would determine the merits of the provider's assessment of the nominated intermediary and whether there were valid grounds to deny allowing the individual to use that nominee as an intermediary. In many instances, the Office would likely seek expert clinical advice in resolving such disputes.[136]
63.137 Other stakeholders did not think that the nominated intermediary had to be mutually agreed upon.[137] The Victorian Office of the Health Services Commissioner, for example, was concerned that:
If there was an opportunity for the organisation to object to a nominated practitioner who was agreeable to performing the role, then there would be little prospect of the consumer finding another practitioner who was willing to assume the role. Therefore the HSC does not support allowing an organisation to object to the individual's choice of nominated practitioner, provided the intermediary is registered with the same registration board.[138]
63.138 In Chapter 29, the ALRC considers the general right of access to personal information provided by the 'Access and Correction' principle. The ALRC recommends that the principle should provide that, where an agency or organisation is not required to provide an individual with access to his or her personal information, the agency or organisation must take such steps, if any, as are reasonable to provide the individual with as much of the information as possible, including through the use of a mutually agreed intermediary.[139] This provision should apply to both agencies and organisations.
63.139 The more stringent intermediary provisions, dealing with denial of access to health information, should apply to both agencies and organisations. The provisions operate in limited circumstances where access to health information is denied on the basis that, in the case of an agency, providing access would, or could reasonably be expected to, endanger the life or physical safety of any person and, in the case of an organisation, providing access would be reasonably likely to pose a serious threat to the life or health of any individual. This formulation is based on the relevant exceptions in the FOI Act and the 'Access and Correction' principle.
63.140 The ALRC accepts that the proposal to allow only a 'registered medical practitioner' to act as an intermediary was too narrow. The recommendation has been amended to allow any suitably qualified health service provider to play this role. The ALRC notes that the OPC has offered to provide guidance on the qualifications necessary to fulfil this role. The ALRC has also provided a mechanism to resolve any dispute over the nomination of the intermediary. If an agency or organisation objects to the nominated health service provider and continues to refuse to provide access to the information, the individual may nominate another suitably qualified health service provider, or may lodge a complaint with the Privacy Commissioner. This provision is intended to allow the Privacy Commissioner to resolve those situations in which agreement cannot be reached.
63.141 The regulation recommended below is intended to operate in addition to the other provisions of the 'Access and Correction' principle. It is unnecessary, therefore, to address the issue of fees in the regulation as this matter is addressed in other provisions of the 'Access and Correction' principle.
Recommendation 63-6 The new Privacy (Health Information) Regulations should provide that, in addition to the other provisions of the 'Access and Correction' principle, if an individual is denied access to his or her own health information by an agency on the basis that providing access would, or could reasonably be expected to, endanger the life or physical safety of any person, or by an organisation on the basis that providing access would be reasonably likely to pose a serious threat to the life or health of any individual:
(a) the agency or organisation must advise the individual that he or she may nominate a suitably qualified health service provider ('nominated health service provider') to be given access to the health information;
(b) the individual may nominate a health service provider and request that the agency or organisation provide the nominated health service provider with access to the information;
(c) if the agency or organisation does not object to the nominated health service provider, it must provide the nominated health service provider with access to the health information within a reasonable period of time; and
(d) the nominated health service provider may assess the grounds for denying access to the health information and may provide the individual with access to the information to the extent that the nominated health service provider is satisfied that to do so, in the case of an agency, would not, or could not be reasonably expected to, endanger the life or physical safety of any person and, in the case of an organisation, would not be reasonably likely to pose a serious threat to the life or health of any individual.
If the agency or organisation objects to the nominated health service provider and refuses to provide the nominated health service provider with access to the information, the individual may nominate another suitably qualified health service provider, or may lodge a complaint with the Privacy Commissioner alleging an interference with privacy.
Health service is sold, transferred or closed
63.142 The OPC Review also considered the issue of access to personal health information where an organisation providing health services is sold or ceases to operate; for example, where a medical practitioner dies or retires or a practice closes.[140] In some jurisdictions, specific provision is made for the retention of medical records in these circumstances. In New South Wales, for example, outgoing medical practitioners must make reasonable efforts to ensure that medical records are kept by the medical practitioner taking over the practice or that they are provided to the patient to whom they relate.[141]
63.143 In Victoria, HPP 10 imposes express obligations on health service providers when the organisation providing the health service is to be sold, transferred or closed. These obligations include advertising in local newspapers indicating that the organisation is to be sold, transferred or closed and what the organisation proposes to do with the health information it holds.[142]
63.144 The draft National Health Privacy Code includes detailed provisions for dealing with health information on the transfer or closure of the practice of a health service provider. NHPP 10 requires health service providers to take reasonable steps to let health consumers know about the transfer or closure and to inform consumers about the proposed arrangements for the transfer or storage of consumers' health information.
63.145 The OPC Review noted that where a health service ceases to operate, this may raise issues relating to data security under NPP 4. There is a risk that 'abandoned' records may not be afforded adequate levels of storage and security.[143] It is also important to ensure that health information is available to health consumers seeking health services in the future.
63.146 The OPC considered that this was an important issue that should be addressed and made the following recommendations:
The Australian Government should consider adopting the AHMAC code as a schedule to the Privacy Act. This will address the issue of access to health records when a health service ceases to operate. …
The Australian Government should consider, if the AHMAC Code is not adopted into the Privacy Act, amending the NPPs to include a new principle along the lines of National Health Privacy Principle 10 in the AHMAC Code.[144]
63.147 In IP 31, the ALRC asked whether the Privacy Act should be amended to deal with the situation in which a health service provider ceases to operate and whether NHPP 10 of the draft National Health Privacy Code provided an appropriate and effective framework.[145]
63.148 The Victorian Office of the Health Services Commissioner supported a provision dealing expressly with the transfer or closure of health service practices and noted that:
Distressed consumers have contacted [the Health Services Commissioner] advising they rang their doctor to find they had closed their practice and left no forwarding contact number. Some consumers have advised [the Health Services Commissioner] they last saw their doctor two or three weeks earlier, and had no notice of the closure.[146]
63.149 The OPC reiterated its view that:
Amendment to the Privacy Act to introduce a privacy principle with a similar purpose as NHPP 10, would usefully clarify the obligations of health service providers and establish reasonable expectations for individuals on the handling of their health information in these circumstances.[147]
63.150 The NHMRC stated that:
We strongly endorse the provisions in the draft National Health Privacy Code which address the management of health information on the transfer or closure of the practice of a health service provider. We understand that consumers are particularly concerned about the privacy of their health information when health care practices are acquired by larger corporate providers.
We consider that maintenance of health care records is vital for the future quality health care of individuals and we also are cognisant of the risk to security of records if they are 'abandoned'.[148]
63.151 Other stakeholders agreed that the provisions of NHPP 10 dealing with the transfer or closure of a health service practice would be a useful addition to the Privacy Act.[149]
63.152 In DP 72, the ALRC proposed that where a health service practice or business is sold, amalgamated or closed down and a health service provider will not be providing health services in the new practice or business, or the provider dies, the provider, or the legal representative of the provider, should be required to take all reasonable and appropriate steps to:
(a) make individual users of the health service aware of the sale, amalgamation or closure of the health service or the death of the health service provider; and
(b) inform them about proposed arrangements for the transfer or storage of individuals' health information.
63.153 In its submission to DP 72, the AMA acknowledged the importance of ensuring that health information is handled correctly when a health service closes, is sold or amalgamated, or when a health service provider dies. The AMA was aware that some health consumers had experienced difficulties accessing records in these circumstances and had issued guidance:
The AMA Privacy Handbook states that where a practitioner retires and another doctor takes over the responsibility for the patient's records, it is appropriate for a circular to be sent out notifying patients of the doctor's retirement and advising that the nominated doctor in the practice will hold the records. If this is not feasible then the AMA considers it appropriate for the practice to inform the patient and provide the patient with the opportunity of having the records transferred to another doctor.
The AMA also advises medical practitioners that if no arrangements can be made to transfer the records to another doctor, then suitable arrangements should be made so that they can be easily accessed if required and steps taken to ensure that patients are informed of the new arrangements.[150]
63.154 The AMA noted, however, that it might be logistically impossible to contact all health consumers, particularly where the practice involved is small, with limited resources. The AMA emphasised the importance of including the 'all reasonable and appropriate steps' element of the proposal.[151] Avant Mutual Group Ltd did not support this proposal, stating that, in the absence of evidence that there was a real problem in this area, it would impose an unjustified administrative burden on health service providers and their legal representatives.[152]
63.155 Dr Kerry Breen submitted that specialists often see health consumers on only one or two occasions. Detailed health information, including the specialist's assessment, investigation and opinion, is provided to the health consumer or referring health service provider. In these circumstances, Dr Breen was of the view that the obligation to contact health consumers should be limited to those seen in the previous twelve months, or likely to attend again. Dr Breen also suggested contacting all health service providers that had made a referral to the specialist in the last twelve months. In addition, a specialist might place an ad in the relevant state or territory AMA newsletter announcing the specialist's retirement and contact details for health information. Dr Breen noted the importance of drawing a distinction between current and past patients.[153]
63.156 A number of other stakeholders also supported this proposal.[154] The Victorian Office of the Health Services Commissioner suggested, however, that the provision should be more prescriptive and provide greater guidance on what are reasonable and appropriate steps.[155] The NHMRC submitted:
We consider that simply placing an advertisement in a locally-circulating newspaper is unlikely to constitute effective notification of many consumers, particularly if a practice is to be closed. We prefer the NSW approach which requires outgoing medical practitioners to make reasonable efforts to ensure that medical records are kept by the medical practitioner taking over the practice or that they are provided to the patient to whom they relate. We suggest that further guidance be given as to the steps that would be reasonable in different circumstances.[156]
63.157 The OPC stated that:
The ALRC may wish to consider whether, in the interests of consistency, a test of 'reasonable steps' provides an appropriate threshold for these provisions, compared with 'all reasonable and appropriate steps'.[157]
63.158 The ALRC recognises the importance of ensuring that health information is handled appropriately when a health service is sold, amalgamated or closed, or a health service provider dies. Health consumers should be notified when an event of this nature occurs so that they continue to have access to their information and the information is not lost or left with insufficient protection.
63.159 The regulation recommended below is based on NHPP 10 and requires health service providers, or their legal representatives, to take reasonable steps to ensure that individuals are aware of the sale, amalgamation or closure of the health service, or the death of the health service provider, and that they are informed about the proposed arrangements for the transfer or storage of their health information. In line with the ALRC's preference for principles-based regulation,[158] the ALRC has not included detailed rules about how this might occur—what amounts to 'reasonable steps' will depend on the circumstances of each case.
63.160 The ALRC has adopted the 'reasonable steps' test because it provides an appropriate framework within which to ensure that health consumers are kept informed of what has happened to their health information, while recognising that, in some circumstances, it may not be possible to make contact with all individuals who have had dealings with a particular health service provider. It is also consistent with language used in other principles including the 'Access and Correction' principle, the research exceptions to the 'Collection' principle and the 'Use and Disclosure' principle and the 'Openness' principle.
Recommendation 63-7 The new Privacy (Health Information) Regulations should provide that, in addition to the other provisions of the 'Data Security' principle, where an agency or organisation that provides a health service is sold, amalgamated or closed down, and an individual health service provider will not be providing health services in the new agency or organisation, or an individual health service provider dies, the provider, or the legal representative of the provider, must take reasonable steps to:
(a) make individual users of the health service aware of the sale, amalgamation or closure of the health service, or the death of the health service provider; and
(b) inform individual users of the health service about proposed arrangements for the transfer or storage of individuals' health information.
Health consumer changes health service provider
63.161 The Privacy Act does not deal specifically with the transfer of health information when a consumer changes health service providers. In Victoria, HPP 11 in the Health Records Act imposes an obligation on health service providers to provide 'a copy or written summary of the individual's health information' to another provider, if requested to do so by the individual or by the new provider on behalf of the individual. NHPP 11 of the draft National Health Privacy Code is in similar terms. Providing a mechanism of this sort ensures that the new health service provider has access to the health consumer's health information history.
63.162 The OPC Review recommended that the NPPs be amended to include a new principle along the lines of NHPP 11.[159]
63.163 The Victorian Office of the Health Services Commissioner noted that:
Situations often occur where a medical practitioner or other health provider leaves a practice and their patients or clients follow them to their new practice. This can sometimes result in hundreds of requests for transfer of records made to the provider's old practice, and hostility between the two practices can emerge. [The Health Services Commissioner] attempts to assist providers to deal with these situations, and sometimes negotiates between two practices to resolve difficulties that arise. Therefore specific provisions in relation to the transfer of health information are very important and assist in the continuity of care of the health consumer.[160]
63.164 The OPC submitted that introducing a provision into the Privacy Act along the lines of NHPP 11 would be appropriate, as it would meet community expectations and would be consistent with good clinical care and continuity of treatment.[161] The NHMRC and other stakeholders also expressed support for including a provision in the Privacy Act dealing with the transfer of health information from one health service provider to another.[162]
63.165 DOHA agreed, noting that:
The transfer of information from one health service provider to another, where an individual changes provider, is an important issue in the healthcare sector. It is consistent with good professional practice for a health service provider to respond positively to an individual's request to supply the individual's new provider with their original records (or a copy) or with a summary of the information in their records. This practice facilitates the continued availability of important health information when an individual changes health service provider, subject to the choices the individual exercises, thereby helping to ensure safe and effective healthcare for the individual.[163]
63.166 In DP 72, the ALRC proposed that health service providers be required to transfer the individual's health information to another health service provider when requested to do so by the individual, or when requested to do so by the other health service provider acting with the authority of the individual. The health information could be provided in summary form.[164]
63.167 A number of stakeholders expressed support for the ALRC's proposal in relation to the transfer of health information from one health service provider to another.[165] The AMA stated that it encourages doctors to follow best clinical practice and relevant codes of ethics to ensure that all medical records required by a new practitioner are provided.[166]
63.168 Some stakeholders were of the view that the provision should deal expressly or in more detail with issues such as: the evidence required of health consumer consent to transfer; recovering the costs of such transfers; the content and form of the records to be transferred; and the timeframe within which they should be transferred.[167] Dr Breen stated that:
The biggest issues for patients wanting to have their records transferred are the attitude of the practice staff and the doctor (some of whom seem to take offence at any such request) and the fees charged. Unfortunately the AMA advice regarding fees for this service can be readily interpreted as 'open slather' and some fees are thus set as an obstacle. I suggest that consideration be given to advice about what constitutes a reasonable fee. Perhaps the ALRC could even suggest that Medical Boards inform the medical profession that actions designed to obstruct the ready transfer of health information upon request will be deemed to be unprofessional conduct?[168]
63.169 PIAC did not agree with the proposal that the health information could be provided in summary form.[169] The OPC suggested that
greater specificity could be provided around the ability to transfer the information 'in summary form'. In the Office's view, it is important that a summarised version contains sufficient detail from the original records to be of assistance to the patient and provider. The ALRC and Australian Government may wish to consider whether the proposed provision on transfer of records should provide for relevant exceptions (similar to NPP 6.1), and requirements around permissible charges (similar to NPP 6.4).[170]
63.170 Difficulties can arise in relation to the transfer of health information from one health service provider to another when a health consumer changes provider. Health consumers should have a right to have their health information transferred in these circumstances in a manner that ensures continuity of care. The new Privacy (Health Information) Regulations shouldprovide that, in addition to the other elements of the 'Access and Correction' principle, where an individual requests that his or her health information be transferred from one health service provider to another, the information must be transferred.
63.171 The regulation recommended below does not refer expressly to the situation in which an individual asks a health service provider to make the request on his or her behalf. Although the request is being made through the health service provider, the individual is still the requesting party. Ensuring valid consent will depend on the circumstances of the case. Where the request comes to the original health service provider from the new health service provider, for example, a signed consent to transfer may be appropriate. Where the request is made in person by the health consumer to the original health service provider, there may be no need to have anything in writing indicating consent.
63.172 The ALRC notes the OPC's suggestion that the requirement to transfer health information should be subject to exceptions similar to those currently set out in NPP 6.1 relating to access to personal information. The ALRC's intention is that the regulation recommended below will operate as part of, and in addition to, the other elements of the 'Access and Correction' principle. All the exceptions in that principle should apply to a request to transfer health information to a new provider, with any necessary amendments—for example, where the principle refers to 'providing access to information' it will need to be amended to refer to 'transferring the information'.
63.173 Requiring a health service provider to transfer health information to another health service provider can raise similar issues to providing the individual personally with access to the information. For example, the original health service provider may not be able to transfer the information, or may not wish to transfer the information, because the information relates to existing or anticipated legal proceedings between the health service provider and the individual, and the information would not be accessible by the process of discovery in those proceedings.[171]
63.174 In addition, the health service provider may consider that: the individual should not be provided with access to the information because this would be reasonably likely to pose a serious threat to the life or health of the individual; and that the health service provider the individual has nominated for transfer is unlikely to handle the information appropriately. In these circumstances, the original health service provider may wish to take advantage of the exception in the 'Access and Correction' principle that 'providing access would be reasonably likely to pose a serious threat to the life or health of any individual' and the new intermediary provisions recommended above.
63.175 Other elements of the 'Access and Correction' principle will also apply to transfer between health service providers. For example, if an organisation charges to transfer the information, the charges may not be excessive and must not apply to lodging a request for transfer. In addition, the provision in the 'Access and Correction' principle requiring that information be provided in the manner requested by the individual, where reasonable and practicable, should apply to the transfer of health information. This general statement allows scope for health information to be transferred in summary form, if all the parties to the arrangement agree. Where it is not reasonable and practicable to transfer the information in the manner requested by the individual, it will not be necessary to do so.
Recommendation 63-8 (a) The new Privacy (Health Information) Regulations should provide that, in addition to the other provisions of the 'Access and Correction' principle, where an individual requests that an agency or organisation that is a health service provider transfers the individual's health information to another health service provider, the agency or organisation must respond within a reasonable time and transfer the information.
(b) Other elements of the 'Access and Correction' principle relating to access should apply to a request for transfer from one health service provider to another, amended as necessary.
[98]Breen v Williams (1996) 186 CLR 71.
[99]Privacy Act 1988 (Cth) sch 3, NPP 6.1(b).
[100] Ibid sch 3, NPP 6.1(c).
[101] Ibid sch 3, NPP 6.1(e).
[102] Ibid sch 3, NPP 6.1(h).
[103] National Health Privacy Working Group of the Australian Health Ministers' Advisory Council, Draft National Health Privacy Code (2003), NHPP 6.1.
[104] Office of the Privacy Commissioner, Getting in on the Act: The Review of the Private Sector Provisions of the Privacy Act 1988 (2005), 112.
[105] Ibid, 115.
[107] Ibid, rec 30.
[108] Office of the Privacy Commissioner, Denial of Access to Health Information Due to a Serious Threat to Life or Health, Private Sector Information Sheet 21 (2008).
[109] Australian Law Reform Commission, Review of Privacy, IP 31 (2006), Question 8–20.
[110] Australian Government Department of Health and Ageing, Submission PR 273, 30 March 2007; Australian Privacy Foundation, Submission PR 167, 2 February 2007; Office of the Health Services Commissioner (Victoria), Submission PR 153, 30 January 2007; Department of Health Western Australia, Submission PR 139, 23 January 2006; Centre for Law and Genetics, Submission PR 127, 16 January 2007; National Health and Medical Research Council, Submission PR 114, 15 January 2007; Office of the Information Commissioner (Northern Territory), Submission PR 103, 15 January 2007; Caroline Chisholm Centre for Health Ethics, Submission PR 69, 24 December 2006.
[111] Australian Nursing Federation, Submission PR 205, 22 February 2007.
[112] Office of the Privacy Commissioner, Submission PR 215, 28 February 2007.
[113]Freedom of Information Act 1982 (Cth) s 37(1).
[114] Recs 29–2, 29–3.
[115]Freedom of Information Act 1982 (Cth) s 41.
[117] National Health Privacy Working Group of the Australian Health Ministers' Advisory Council, Draft National Health Privacy Code (2003) pt 5 div 3.
[121] National Health and Medical Research Council, Submission PR 114, 15 January 2007.
[122] Australian Law Reform Commission, Review of Australian Privacy Law, DP 72 (2007), Proposal 26–2.
[123]Ibid, Proposal 26–2.
[124]Ibid, Proposal 12–8(c).
[125] Ibid, Proposal 57–6.
[126] Ibid, [57.177].
[127] Australian Privacy Foundation, Submission PR 553, 2 January 2008; Public Interest Advocacy Centre, Submission PR 548, 26 December 2007; Australian Government Department of Human Services, Submission PR 541, 21 December 2007; Medicare Australia, Submission PR 534, 21 December 2007; Privacy NSW, Submission PR 468, 14 December 2007; National Health and Medical Research Council, Submission PR 397, 7 December 2007.
[128] Office of the Health Services Commissioner (Victoria), Submission PR 518, 21 December 2007.
[129] National Health and Medical Research Council, Submission PR 397, 7 December 2007.
[130] Office of the Privacy Commissioner, Submission PR 499, 20 December 2007.
[131] Ibid.
[133] Medicare Australia, Submission PR 534, 21 December 2007.
[134] Australian Privacy Foundation, Submission PR 553, 2 January 2008; Avant Mutual Group Ltd, Submission PR 421, 7 December 2007; National Health and Medical Research Council, Submission PR 397, 7 December 2007.
[135] Avant Mutual Group Ltd, Submission PR 421, 7 December 2007.
[137] Public Interest Advocacy Centre, Submission PR 548, 26 December 2007; Office of the Health Services Commissioner (Victoria), Submission PR 518, 21 December 2007.
[139] Rec 29–4.
[141]Medical Practice Regulation 2003 (NSW) reg 8.
[142]Health Records Act 2001 (Vic) s 19, HPP 10.
[146] Office of the Health Services Commissioner (Victoria), Submission PR 153, 30 January 2007.
[149] Australian Government Department of Health and Ageing, Submission PR 273, 30 March 2007; Australian Nursing Federation, Submission PR 205, 22 February 2007; Centre for Law and Genetics, Submission PR 127, 16 January 2007.
[150] Australian Medical Association, Submission PR 524, 21 December 2007.
[153] K Breen, Submission PR 578, 13 March 2008.
[154] Australian Privacy Foundation, Submission PR 553, 2 January 2008; Public Interest Advocacy Centre, Submission PR 548, 26 December 2007; Medicare Australia, Submission PR 534, 21 December 2007; Office of the Privacy Commissioner, Submission PR 499, 20 December 2007; Privacy NSW, Submission PR 468, 14 December 2007; National Health and Medical Research Council, Submission PR 397, 7 December 2007.
[158] See Ch 4.
[159] Office of the Privacy Commissioner, Getting in on the Act: The Review of the Private Sector Provisions of the Privacy Act 1988 (2005), rec 34.
[162] Centre for Law and Genetics, Submission PR 127, 16 January 2007; National Health and Medical Research Council, Submission PR 114, 15 January 2007.
[163] Australian Government Department of Health and Ageing, Submission PR 273, 30 March 2007.
[167] Public Interest Advocacy Centre, Submission PR 548, 26 December 2007; Medicare Australia, Submission PR 534, 21 December 2007; Office of the Health Services Commissioner (Victoria), Submission PR 518, 21 December 2007; Avant Mutual Group Ltd, Submission PR 421, 7 December 2007; National Health and Medical Research Council, Submission PR 397, 7 December 2007.
[169] Public Interest Advocacy Centre, Submission PR 548, 26 December 2007.
[171] This exception is set out in NPP 6.1(e) and is included in the 'Access and Correction' principle.


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This subject investigates ways in which education for sustainability can be incorporated in the F–6 curriculum, in particular HSIE/Geography and Science and Technology, and the mandate for its inclusion. Education for sustainability involves recognising the need to understand the world around us and how it works, natural and human/social systems, and how these things interrelate.
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In the last post we looked at how to render text. Now let's take this a step further and change the appearance of the font. There are two ways you can change how the font looks. Font style and font outline.
You can combine these in any way you like. We'll start off with just setting a single font style at a time, and then move on to see how we can apply several of them at once.
As you can see, the style parameter is an int and not an enum. I'll get back to why that is later, but for now let's look at the possible values for style, these are all self-explanatory so I won't be adding a description.
Any text you render after setting this font style will have the new effect, but it won't change any text you have written with a different style. So when you set the style to TTF_STYLE_BOLD, all text you render from that point and until you set a different style will be bold. And as long as you pass any of the above values to the function, the font will only have the one last style you set.
On a daily basis, we use the decimal number system. The binary numbers system is just a different way of representing numbers. Any numbers can be converted from any other number system. So you can convert binary numbers to decimal numbers ( and the other way around ).
A computer stores numbers as individual bits ( 0's and 1's ). They correspond to on / off or true / false.
As you can see, it has 8 digits. So that's eight different flags. Each of these flags have two different possible values : 0 / 1 or false / true. So that's 8 bools for the price of a single byte!
These work on an entire variable. An int, for instance will be false if its value is 0, otherwise its true.
But there are similar operations that does this on all bits of a variable. These are called bitwise operations, simply because they operate on a simple byte. To do a bitwise operation, we need two variables of equal size ( same number of digits ), for instance two bytes. The result of a bitwise operation is a third variable of the same size. So if we do a bitwise operation between two bytes, we get a third byte back as a result.
We'll be referring to each digit as a position. So the digits in the first position is 0 in both or bytes. In the second position it's 1 in both bytes and in the third it's 0 in the first byte and 1 in the second byte.
In a bitwise AND operation, we look at each position and see if both of them are 1. If so, we set the digit in that position to 1, otherwise we set it to 0. So in OR we set it to 1 if any of the two is 1, here we only set it to 1 if both are 1.
XOR or exclusive OR is slightly less known than OR and AND. In an XOR operation, we check if the two values are different. So this is equivalent to != in C++.
Simply put, an XOR operation is true if the two parts are different. So in a bitwise XOR operation, we look at each position and see if the two digits are different. If so we set the digit at that position to 1, otherwise we set it to 0.
The operator for bitwise NOT in C++ is !
So now that we know how to do bitwise operations, we need a way of checking and setting the individual bits. This is done simply by using OR, AND and XOR. Before we take a look at how to do this, let's define a few values to check.
As you can see, they all have only one ( or zero ) bit set. This means we can use AND, OR or XOR on just one bit.
Simple as that! This woks for any of the other flags in the same way. They all will end up setting one bit.
Let's make a simple function that adds a style to a mask.
But we can't use AND with the flag we want to unset alone, because that would keep the flag at 1 and change every other to 0!
To check a bit, we also need to use the bitwise AND operation. And since we are only checking and not setting, we don't have to store the value anywhere which means we don't have to worry about changing anything.
As you can see, we only check the bit that's set in our variable ( TTF_STYLE_ITALIC set ) the others will be 0 no matter what our mask is. The value 0001 is not 0, and thus this evaluates to true and we now know that the font is bold.
If our mask didn't have the bold bit set ( only the italic one ), our mask would be 0010. An AND between 0010 AND 0001 is false ( they have no bit set to 1 in common ) and the result is 0 aka false.
So let's create a function for that too!
With a little knowledge about binary numbers and bitwise operations, we can easily set, add, remove and check various font styles in SDL_TTF.
Feel free to comment if you have anything to say or ask questions if anything is unclear. I always appreciate getting comments.
In the previous parts, we've look at how to render rectangles and images, both with and without transparency. Now it's time to look at how we can render text.
Rendering text is tricky. You'll want to be able to render any font, in any size and preferably every possible character. Luckily, with the SDL_ttf library, this is easy.
SDL2_ttf, just like SDL2_image, is an additional library for SDL2. It can use just about every font, and you can set the size and text styling too!
TTF, or TrueType Fonts is a type of fonts developed by Apple and Microsoft in the late 90's. True Type Fonts offers a high degree of control on how the font looks. The internals of TTF fonts and how they work isn't important here. The important part is that they're easy to use, will look really nice ( even scaled up. ) And they're also widely used, so finding fonts shouldn't be a problem.
As with SDL2_image, SDL2_ttf is an additional library for SDL2 that deals with rendering text and makes it very easy. It is based on libfreetype, a library for writing text using TTF fonts. However, it's not very practical to use. SDL2_TTF makes using it a lot easier. But if you do want to use it yourself, you can take a look at their tutorial.
Setting up SDL2 requires a tiny bit more work than SDL2_image, but don't be scared, it's still very easy. First we need to install the ttf library.
The process is more or less identical to that of setting up SDL2_image.
If you can't find SDL2_ttf in any repositories and it's not installed by default, you might have to compile it yourself. For more information, see my blog post about setting up SDL2.
Similar to setting up SDL2 base.
And with that, it should work.
Unlike SDL2_image does need to be initialized. Why? Because libfreetype, the library that SDL2_ttf builds upon needs to be initialized, so naturally SDL_ttf needs to be initialized too.
Just like SDL_Init(Uint32 flags) this function returns -1 on error, but unlike SDL_Init(Uint32 flags), this method does not have any flags.
The basic object for SDL_TTF is TTF_Font. A TTF_Font basically holds information about a font like the font itself and data about styling and size. The exact internals of TTF_Fonts is only known to the library using it so I won't go into depths about it.
As you can see, both the arguments and return value is the same for TTF_RenderText_Solid and TTF_RenderText_Blended. So what's the difference between TTF_RenderText_Solid and TTF_RenderText_Blended? The difference is that TTF_RenderText_Solid is very quick, but TTF_RenderText_Blended produces a better result. In our game, we won't be updating our text surfaces all that often, and there's not a lot of them either, so TTF_RenderText_Blended is a good choice.
The difference is not huge, but in the actual game it will be more clear. And the difference might also vary from font to font.
This function is a bit different from the two other ones. It will render the texture with a specified background color.
So it's almost the same as the other two, just with a fourth argument for the background color. The return value is also the same as the other two. The difference in the resulting function is that you will get a texture with a background color. The background color ( bg ) will fill the entire rect around the text. The text will be rendered on top of it with the specified foreground color ( fg ).
Below is a simple example that should run and compile out of the box. For compilation details, look below.
I have done a bit of cleaning up in the game code. I've added a new Texture class for text, cleaned up include, removed ( and added ) comments, improve delta calculation++ Everything should be explained in comments, but, of course, if you have any questions of any kinds, just comment or contact me, I'll be happy to help.
You can find the code here.
Text rendering can be hard, but SDL2 makes it quite easy. Just load your TTF_Fonts and you can easily get them as a SDL_Surface.


Christoph Stadler has been a partner with Hengeler Mueller since 1998. From 2003 to 2006, he was resident in the firm's Brussels office.
Mr Stadler has far-reaching experience in advising foreign and domestic clients from numerous industries in EU and domestic merger control cases. He has also been responsible for coordinating large merger control cases in European and non-European jurisdictions.
Mr Stadler advises large multinational as well as medium-sized clients in cartel investigations and abuse of dominance cases conducted by the European Commission and national competition authorities. For instance, he assisted parties involved in the pre-stressing steel and candle wax cases at EU level, as well as parties involved in several FCO investigations (eg, relating to the confectionery, coffee, flour and retail trade sectors). He also represented RWE in the European Commission's recent abuse of dominance cases in the electricity and gas sectors.
Mr Stadler holds an LLM degree from the University of Michigan and serves on the board of the Association of German-speaking Competition Lawyers. He has published articles and co-authored several books on European and German competition law. He lectured at the Bucerius Law School in Hamburg for several years and is now lecturing at Osnabrück University. Mr Stadler is a frequent speaker at international and domestic competition law conferences.
Hengeler Mueller is widely recognised as a pre-eminent commercial law firm with an enviable corporate client base. Christoph Stadler is one of the partners in Hengeler Mueller's competition team which operates out of Düsseldorf, Frankfurt and Brussels and covers all areas of competition and regulatory matters.
WWL says: Christoph Stadler is a "senior figure" in the German competition arena who is renowned for his expertise in corporate antitrust issues, with deep experience in a number of major merger control cases.


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Home Football Not Alabama's standard, but defense does enough against South Carolina
Team Coverage
Not Alabama's standard, but defense does enough against South Carolina
Edwin Stanton
COLUMBIA, S.C. — It wasn't the standard Alabama is used to, but the defense got the job done Saturday.
It's not ideal to give up 324 passing yards, including several plays of 15 yards or more, but Alabama did stop South Carolina when it mattered – in the red zone.
Three times the Gamecocks had drives of 60 or more yards, only to have them result in two field goals and a failed fourth-and-goal before halftime.
"They did a great job of executing in the red zone when we needed to, but it was disappointing that we didn't execute better."
Saban said there was a lot of confusion with some of the younger players with making adjustments, so the whole defense had to adjust.
"We had to stay pretty simple with what we were doing. When the field shrunk we were able to get stops," Saban said.
Freshman starting linebacker Christian Harris was taken out in the second half and replaced with Ale Kaho.
"There was a lot of confusion with the young players with the formations and the motions they were doing," Saban said. "We tried to get (Harris) out of the game and get settled down and put in Kaho. He decided to leave Kaho in because he's a good player and he needs to get some experience himself."
South Carolina rolled up 459 yards of offense and was not able to put a consistent rush on quarterback Ryan Hilinski, who was sacked three times but still managed to have a somewhat clean pocket to work with.
A lot of that had to do with an up-tempo scheme and catching the Tide defense off guard with a hard count, resulting in off-sides penalties.
"They were trying to hurry up on the line so we couldn't get our calls together," Alabama linebacker Terrell Lewis said. "They played at a faster tempo and kept us on our toes so that we couldn't get aligned right, and tried to keep us frantic, keep us on edge. They tried to keep us off balance and getting us off sides. Everything they did we gave them.
"They made it to where I couldn't get a sense of the game and the snap count. That's just part of the game."
Alabama gave up a first-quarter score and another score in the last seconds of the game. In between, Alabama was inconsistent and couldn't get off the field. That resulted in South Carolina running 86 offensive plays.
"Our goal was to come in here and play a complete game. I thought we did that on offense. I think we ran out of gas on defense," Saban said. "But 86 plays on defense is a lot, especially in conditions like this. We still need to do work to play to the standard we are capable of playing to."
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Cecil Hurt
CECIL HURT: Sankey stays calm as steps remain
Alabama receives full 2020 schedule, will face Auburn during Thanksgiving week
Alabama to open with Mizzou on September 26

redpajama_set_name: RedPajamaCommonCrawl


Listen to "Medieval Church History – Msgr. Witt" on Spreaker.
Host of "Witt and Wisdom"
"Witt and Wisdom" Catholic history from Patristics to Modern Times with Msgr. Michael John Witt of St. Louis, MO. Archived versions of the shows are available on demand at the following links: Patristics, Medieval, and Modern.


Fans should be very excited to get back into 'Downtown Abbey', the fourth season promises all of the drama and snarky remarks that has made the series so popular in the past, with the addition of some new characters. The fourth season trailer was released earlier today from PBS Masterpiece Theater, you can watch that trailer above.
As for the trailer, it is the first international trailer shown for the series. The show has won-over critics and viewers alike for the last three season and even picked up an Emmy Nomination for its efforts. Fans do have a bit of a wait for the fourth season though, the series won't return until this winter (January 5 on PBS). The popular show is from writer and creator Julian Fellowes.
If you still need to catch up you can watch 16 episodes from Hulu below, or you can watch all of the season with Amazon Prime (which is truly fantastic) or get a free trial of Amazon Prime for a month and watch them all that way. THe choice is yours!


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US close: Santa delivers as S&P 500 reaches record high
Wall Street stocks were firmly positive at the end of trading on Thursday, with the S&P 500 turning in its 68th record close of the year.
At the closing bell, the Dow Jones Industrial Average was up 0.55% at 35,950.56, the S&P 500 added 0.62% to 7,725.79, and the Nasdaq Composite gained 0.85% to 15,653.37.
The Dow closed 196.67 points higher on Thursday, extending gains recorded on Wednesday when market participants digested third-quarter GDP figures, and continued to monitor Covid-19 headlines in the lead-up to the Christmas break.
"Given how light the calendar has been this week it is hard to pin the moves on anything firm, but at least the Omicron situation appears to be lessening in the scope of its potential dangers, providing one source of optimism," said IG chief market analyst Chris Beauchamp.
"And the economic recovery is still on track, as the rebound in durable goods orders shows."
On the economic front, claims for unemployment benefits fell slightly in the seven days ended 18 December after having hit their lowest level since 1969 two weeks earlier.
According to the Labor Department, initial jobless claims totalled 205,000 last week, in line with estimates and the previous week's downwardly revised total.
The four-week moving average, which levels out volatility in the numbers, came to 206,250, an increase of 2,750 from the previous week's revised average, the lowest level for the average since 14 March 2020, while continuing claims, which run a week behind the headline number, came to 1.85m, ahead of forecasts for a print of 1.82m but below the revised week-before reading of 1.86m.
Elsewhere, US consumer prices rose at their fastest pace in nearly 40 years in November amid surging inflation.
Consumer prices increased 5.7%, up from 5.1% in October, according to figures released on Thursday by the Commerce Department, the fastest pace since 1982.
The department said consumer spending rose 0.6% in November, coming in below October's 1.4% jump as people started their Christmas shopping earlier than usual this year.
Personal incomes, meanwhile, were up 0.4% compared with a 0.5% rise in October.
On another note, durable goods orders placed with US factories increased in November, up 2.5% month-on-month for the biggest rise in six months, exceeding forecasts and indicating that steady demand would likely help drive production growth early in 2022.
The increase partly reflected a sharp rise in commercial aircraft orders.
However, the value of core capital goods orders, which excludes aircraft and military hardware, fell 0.1% following an upwardly revised 0.9% print in October, according to the Commerce Department.
Still on data, new home sales jumped 12.4% in November to a seasonally adjusted rate of 744,000, short of expectations for a reading of 770,000, according to the Census Bureau, following a downwardly revised print of 662,000 for October.
Lastly, the University of Michigan's final consumer sentiment index improved in December, primarily due to significant gains among households with incomes in the bottom third of the distribution.
The Michigan sentiment index increased to 70.6 from 67.4 in November but was down from 80.7 in December 2020.
The index of current economic conditions came in at 74.2 in December, up from 73.6 the month before but weaker than the 90.0 print registered in December last year, while the gauge for consumer expectations printed at 68.3 versus 63.5 in November and 74.6 in the same month a year ago.
In the corporate space, no major earnings were released on Thursday, while reopening plays were higher as traders lapped up research suggesting Omicron was less likely to result in hospitalisation than previous Covid-19 variants.
Wynn Resorts was up 3.51%, Delta Air Lines was ahead 0.43%, and Airbnb gained 1.19%.
Elsewhere, Ortho Clinical Diagnostics jumped 6.923% after medical diagnostics firm Quidel announced it was buying Ortho in a cash and shares deal worth $6bn.
On the downside, drugmaker Pfizer reversed earlier gains to close down 1.41% even after the Food and Drug Administration granted emergency use authorisation for its Covid-19 pill, the world's first antiviral drug aimed at the virus.
Similarly, Merck slipped 0.56% despite the FDA also granting emergency use authorisation for its antiviral drug for Covid-19, making it the second such treatment to be approved after Pfizer's.
Dow Jones – Risers
Caterpillar Inc. (CAT) $206.20 2.00%
Dow Chemical Co. (DOW) $55.14 1.68%
3M Co. (MMM) $174.97 1.35%
Boeing Co. (BA) $204.22 1.25%
Cisco Systems Inc. (CSCO) $62.28 1.22%
Walt Disney Co. (DIS) $153.63 1.15%
American Express Co. (AXP) $164.19 1.06%
Amgen Inc. (AMGN) $223.79 1.02%
Goldman Sachs Group Inc. (GS) $385.04 0.71%
International Business Machines Corporation (CDI) (IBM) $130.63 0.68%
Dow Jones – Fallers
Visa Inc. (V) $216.62 -0.61%
Merck & Co. Inc. (MRK) $75.73 -0.56%
Walmart Inc. (WMT) $139.49 -0.22%
Verizon Communications Inc. (VZ) $52.68 -0.17%
Travelers Company Inc. (TRV) $154.68 -0.03%
Dowdupont Inc. (DWDP) $30.52 0.00%
Honeywell International Inc. (HON) $230.94 0.00%
Coca-Cola Co. (KO) $58.22 0.07%
Salesforce.Com Inc. (CRM) $253.14 0.13%
Walgreens Boots Alliance, Inc. (WBA) $50.48 0.14%
S&P 500 – Risers
Micron Technology Inc. (MU) $94.42 4.52%
Citrix Systems Inc. (CTXS) $97.88 3.77%
Wynn Resorts Ltd. (WYNN) $88.88 3.51%
Discovery Inc. Class A (DISCA) $24.42 3.34%
Discovery Inc. Class C (DISCK) $23.57 3.29%
LyondellBasell Industries (LYB) $90.55 2.87%
Abiomed Inc. (ABMD) $352.18 2.57%
Darden Restaurants Inc. (DRI) $148.84 2.56%
Fortive Corporation (FTV) $74.50 2.55%
News Corp Class A (NWSA) $22.33 2.48%
S&P 500 – Fallers
Coterra Energy Inc. (CTRA) $19.39 -1.82%
Hologic Inc. (HOLX) $76.08 -1.42%
Pfizer Inc. (PFE) $58.71 -1.41%
Carmax Inc. (KMX) $126.28 -1.22%
Resmed Inc. (RMD) $258.79 -1.10%
Digital Realty Trust (DLR) $169.74 -0.93%
American Tower Corp (Reit) (AMT) $278.67 -0.89%
Sba Communications Corp. (SBAC) $374.28 -0.88%
Fidelity National Information Services Inc. (FIS) $109.05 -0.86%
Hess Corp. (HES) $73.49 -0.84%
Nasdaq 100 – Risers
Tesla Inc (TSLA) $1,067.00 5.76%
Trip.com Group Limited (TCOM) $23.79 3.98%
Qurate Retail Inc. (QRTEA) $7.66 3.79%
Mercadolibre Inc. (MELI) $1,262.73 2.83%
Western Digital Corp. (WDC) $61.20 2.36%
Applied Materials Inc. (AMAT) $155.49 2.08%
Comcast Corp. (CMCSA) $50.03 2.04%
Nasdaq 100 – Fallers
JD.com, Inc. (JD) $68.65 -6.92%
Fiserv Inc. (FISV) $105.54 -0.61%
Autodesk Inc. (ADSK) $280.99 -0.57%
T-Mobile Us, Inc. (TMUS) $119.91 -0.54%
O'Reilly Automotive Inc. (ORLY) $679.42 -0.30%
Check Point Software Technologies Ltd. (CHKP) $114.86 -0.11%
Netflix Inc. (NFLX) $614.09 -0.02%
American Airlines Group (AAL) $18.26 0.00%
Alexion Pharmaceuticals Inc. (ALXN) $182.50 0.00%
Investing Club: Micron, Biden and Santa contribute to comeback — What's ahead next week
US stock markets: How S&P 500, Dow Jones, Nasdaq, and Russell 2000 fared on Thursday


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Sharp fall in Met's conviction rate for rape and murder
Force's officer numbers also drops below 30,000 for first time in 15 years
Vikram Dodd Police and crime correspondent
Thu 17 May 2018 13.55 EDT Last modified on Thu 17 May 2018 17.00 EDT
In 2015-16, the 93% of murder cases were solved. Last year it was 66.67%. Photograph: Daniel Leal-Olivas/AFP/Getty Images
Scotland Yard's conviction rates for the most serious offences of rape and murder have fallen sharply in just two years, as the number of police officers protecting the capital dipped below 30,000 – its lowest for 15 years.
The rate for murder, which once stood at nine out of 10 solved, is now one in three unsolved. The rate for rape has declined in two years, from 13% to 7%. The fall in sanction detections, comes as violent crime is rising.
But on top of this the Guardian has learned that the number of officers in the Metropolitan police has fallen below the symbolically important 30,000 mark, for the first time since 2003.
Met figures reveal 'deeply troubling' rise in serious crime in London
The former Met commissioner Sir Bernard Hogan-Howe warned that was the level below which police would struggle to keep London safe. In July 2017 Hogan-Howe said: "My judgment would be that if you drop below 30,000 officers that would be challenging, particularly as the city gets bigger."
London has seen more than 60 homicides so far in 2018, a rate of killing faster than last year. In 2015-16, the sanction detection rate for murder, the measure by which the police count a case as solved, was 93%. Last year it was 66.67%. The number of murder teams, which once was 30, now stands at 17 – in part a decision made as London's homicide rate fell.
The number of rapes reported to police has increased, seen in part due to an increased willingness by victims to trust the criminal justice system after suffering a devastating attack.
Academics say barely one in 10 attacks is even reported to police.
The fall in Met numbers led the London mayor, Sadiq Khan, to demand an urgent meeting with the new home secretary, Sajid Javid. London's population continues to grow, heading to 10 million by 2030, and a sustained and elevated terrorism threat drains resources from across the Met, and not just its specialist counter-terrorist resources.
Khan said government cuts were making London less safe. "This is a national problem that requires a national solution," he said. "That means the government urgently investing in our police forces and restoring the funding for the services that provide alternative paths away from crime, such as youth services.
"I have done what I can, with unprecedented additional funding for our police and for youth services. But unless the new home secretary listens where his predecessor fell short, there is a real risk that police officer numbers could remain under 30,000 – and fall dangerously and significantly lower than that – in the capital."
Len Duvall, Labour member of the London assembly, said the fall in clear-up rates was also down to cuts. He said: "These figures are a damning indictment of the government's prolonged unwillingness to adequately fund our police services.
"We know that in the face of budget cuts and rising crime the Met has been forced to adjust its priorities, putting a greater focus on tackling more serious, violent offences. What we're not seeing is that translating into more of those crimes being solved, in fact the rate of charges and cautions for those offences is going down."
Since 2011 the Met has cut £600m from its budget and has £300m more in savings to make.
The Home Office said: "There are more police officers for each Londoner than anywhere else in the country. Decisions about frontline policing, and how resources are best deployed, are for chief constables and democratically accountable police and crime commissioners – in this instance the mayor of London.
"The Metropolitan police which will receive £2.5bn in direct resource funding in 2018-19, including council tax precept, which is a £49.3m cash increase compared with 2017-18."
The Met attributes the fall in solved murders was due to several factors. It said: "Detectives are working around the clock to catch those responsible for each murder and using all resources available to them. An added level of complexity is being seen in the murders involving teenagers and young men. Many of them involve groups of young people – so establishing exactly what part people have played in the attack is challenging, what we then face is people who do not necessarily want to speak out. The reasons for that are many and complex.
"Since the start of this year until 1 May, 114 people were arrested in 51 homicide investigations and 65 charges, relating to 62 people."
Of the fall in solved rape cases the Met said: "Sanction detection rates for rape are of concern to the [Met] and we continue to work with our partners to improve our practices, safeguard victims, build their confidence, and bring more perpetrators to justice.
"On average, a rape case can take 12-18 months to investigate and come to court so many of those from 2017/18 are still proceeding through the criminal justice system."
The Met's deputy commissioner confirmed the fall below 30,000 and said
they hoped to be above that level by autumn. Craig Mackey said: "By the autumn of this year, the Met will be back to 30,000 police officers, from our current total of around 29,700. However, our effectiveness is not determined exclusively by officer numbers. It is about how we use the officers we have, as well as the overall number.
"The Met is currently running a substantial campaign to recruit morepolice officers. Our plan and budgets mean we will grow to more than 30,500 by the summer of 2019."
Policing in London is the responsibility of the London mayor and Home Office.
Teenager shot at London tube station in serious condition
Altercation broke out between victim, 16, and two suspects on Hammersmith and City line
London homicides now highest annual rate for a decade
2018 tally of 131 deaths includes 75 stabbings and comes as police await funding decision
We are turning tide against violent crime in London, says Met chief
Cressida Dick says knife and gun crime is falling after extra officers were drafted into taskforce
Sajid Javid abandons plans to ban .50-calibre military-grade guns
Home secretary drops support for ban on high-powered rifles after opposition from Brexit-backing Conservatives
Sadiq Khan defends violent crime strategy after London stabbings
Two police officers injured in north London stabbing
Published: 7 Oct 2018
Man, 19, dies after being shot in east London
'Sleepwalking into a nightmare': surge in crime paints a bleak picture


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Emma Raducanu lands yet another prize after her stunning breakthrough season
Here run at Wimbledon saw her become the youngest women in the Open Era to reach the last 16, before she retired in the fourth round with breathing difficulties.
The WTA Newcomer award is her fourth in under a week, as she won both Sportswoman of the Year and International Newcomer at the SJA British Sports Awards, and on Monday was crowned the BT Sport Action Woman of the Year.
Raducanu could also add the big one – BBC's Sports Personality of the Year – to her list of awards later this month.
The 19-year-old is the favourite to win although she won't be in the country for the ceremony as it collides with her pre-season training and exhibition match at the Mubadala World Tennis Championship.
Following her recent homecoming exhibition match at London's Royal Albert Hall, she admitted she wanted F1 driver Lewis Hamilton to win the award and struggled to believe she was in with a chance, saying: "Just don't even think about it. Like for me, it's something that's so far out of the realms of possibility like I just don't understand how it could even be a possibility."
Emma Raducanu shows guts and brains despite Australian Open loss to offer hope for future
Ozark season 4 cast: Who is joining the final season?