The following is the National President of the Pharmacy Guild of Australia, Professor Trent Twomey's address to open APP 2025.
Good morning everyone.
Thank you for joining me here at APP 2025 on the Gold Coast.
We will soon be joined by the Prime Minister – our mate Albo – and the Health Minister Mark Butler.
And the Shadow Health Minister Senator the Honourable Anne Ruston will join us here later today.
I’d like to acknowledge the President of the Pharmaceutical Society of Australia, Associate Professor Fei Sim.
And thank you to the past Presidents of the Guild who are here in person: George Tambassis and Kos Sclavos.
And finally – Congratulations and Thank You to the pioneers on the frontline of our profession: the 62 Full Scope of Practice Prescribing Pharmacists and the 500 more currently in training.
8CPA
This time last year I was able to announce that we had reached a Heads of Agreement on the 8th CPA.
This was a profound moment. The culmination of months of hard work by industry and the government to restore our relationship.
The Heads of Agreement relieved the real and natural anxiety that occurs each time reform is divorced from consultation.
Independent analysis by Henry Ergas said that in the second year of the 60 day dispensing policy, in 2025, more than 400 pharmacies risked closure.
This would have negatively affected patient services and community health across the nation.
The 8CPA, finalised in June last year, froze the general co-payment for 18 months until 1 January 2025, and froze the concessional copayment for up to 5 years;
It agreed an important Women’s Health Package for the initiation and supply of hormonal contraception; This programme means pharmacists will prescribe on the PBS for the first time.
The 8CPA committed to automating the PBS safety net, replacing the cumbersome paper-based system that frustrates patients and pharmacists alike.
This is a simple, common-sense reform that most Aussies expect to be in place already.
It can’t come soon enough.
And ultimately, the Government invested over $2 billion extra to ensure the viability of community pharmacy.
The 8CPA meant that, together, the Government and the Guild could prevent those real consequences from materialising.
It re-proved the adage passed down through Guild Presidents since Colin Johns in 1989 – reforms are delivered through Community Pharmacy Agreements, not in spite of them.
Affordability
These commitments have a common theme.
A desire to make medicine more affordable and to realise the potential of community pharmacy.
We play a valuable role in primary healthcare. In making our patients healthier.
We all know that when patients don’t take their medicine, for whatever reason, their outcomes are suboptimal.
I expect you have seen the news this morning that the Government has committed to reducing the PBS co-payment to $25.
It is a Government announcement, and the Prime Minister will be here shortly to speak to you about it.
Your Guild will never stand in the way of reform benefitting our most vulnerable Australians.
You all know from your pharmacy practices that reducing the copayment is 5 times more effective than increasing maximum dispensing quantities.
Since we first reduced the copayment in 2023, we have all suffered sustained and prolonged inflation, eating away at Australians living standards.
If your Guild and the Government had not acted at the last election, the general copayment would have breeched $50 by 1 January 2026.
Reducing the copayment is the most popular cost of living measure introduced by this government.
It was so good that they have agreed to do it again.
The cost-of-living squeeze is real.
You’ve told me about cases in your own practices:
- where mothers are choosing between medicine for them, or for their children.
- Where patients are asking about the minimum dosage so their prescriptions last longer,
- Where patients are asking, which is the most important prescription when they have many?
Being able to see a bulk billed doctor is great. But patients need to be able to afford the prescription that is written.
More people, not fewer, have struggled to afford their prescriptions.
Medication affordability is a healthcare crisis.
1 in 5 Australians has skipped a prescription because of cost in the past three years. That rises to 1 in 3 throughout regional Australia.
Reducing the maximum copayment to $25 cuts the cost of 400,000 prescriptions a week.
This is relief for patients; not new funding for community pharmacies.
Taking this action is not inflationary.
Reducing the co-payment is an elegant answer to a complicated problem.
Making medicine affordable by reducing the co-payment is all upside.
It puts money back in Australians’ hip pocket – the whole $6.60.
It gives patients immediate relief on the cost of their prescriptions.
It means more patients getting exactly what the doctor ordered.
Fewer complications, fewer unnecessary hospital admissions.
Improving the health and wellbeing of millions of Australians.
This can all be achieved with a stroke of a pen and a vote in the Commonwealth Parliament.
Your Guild, and our twenty campaign partners, are standing alongside Australia’s patients.
We will always work in partnership with political leaders to make medicine more affordable.
Trust
One thing I have learnt through my work in community pharmacy and as your National President is that what is good for patients is good for community pharmacy.
Public trust in pharmacists continues to be high. Nearly 80% of people would trust their pharmacist to provide advice for common, non-complex conditions.
Patients continue to value the expertise and accessibility of their community pharmacists.
In capital cities, 96% of people have access to at least one pharmacy within 2.5 km.
Outside capital cities, three in every four people live within 2.5 km of a pharmacy.
93% of pharmacies are open on weekends.
Empowering pharmacists to practise to full scope will be transformational for Australian healthcare.
Like any transformation, it will take time.
But it is not revolution.
It is not evolution.
It is a restoration.
When Medicare was created, it changed how everyday health conditions were treated.
Unintentionally, it directed patients away from their community pharmacist.
Many everyday health conditions became the sole purview of general practitioners.
Full scope is fixing that.
In a healthcare crisis, we are bringing pharmacists off the bench.
Full Scope
I know some community pharmacists here need more convincing on full scope.
And that’s okay.
My role – and your Guild’s role – is to set the direction of travel, create an enabling environment, and to remove barriers.
To be the light on the hill, making the case for pharmacists working to full scope.
Full scope will restore 6,000 community pharmacies to triage and treatment units, akin to urgent care clinics. It means patients will be “thinking pharmacy first”.
If you are interested to find out more about full scope, there are many opportunities within the conference programme.
You can visit your Guild’s stand, speak to prescribing pharmacists, and see a real life consulting room.
Members can also find a range of resources to support your journey including guidelines and discounts for equipment and furniture on our website.
Progress is being made.
Doctor of Pharmacy
There are already 62 prescribing pharmacists in Australia.
Within this next decade, our endeavour is that 80% of community pharmacists are Full Scope Prescribing Pharmacists, and that 80% of community pharmacies are offering Full Scope pharmacist services.
There are currently three institutions teaching four courses to increase your scope of practice.
We are working with universities to create the Doctor of Pharmacy qualification.
Our expectation is this will replace the Bachelor of Pharmacy qualification, so that graduate pharmacists arrive in your pharmacy “Full-Scope ready”.
Training (Retrofitting)
Pharmacists who treat these conditions aren’t winging it.
The training is rigorous, but not onerous.
It takes us out of our comfort zone.
It is rewarding.
And if I can do it, so can you.
Key to the training is clinical observations and being able to treat the whole person.
We need to avoid piecemeal extensions of scope that encourage pharmacists to isolate specific systems.
Pharmacists need to be able to understand, treat and refer for a range of presentations.
MBS v PBS
We have heard loud clear that members want Same Job, Same Pay.
But MBS consultation rights are not the answer.
They never will be.
Community pharmacy has a devoted funding stream.
It’s called the PBS.
Your Guild will not rest until PBS prescribing rights, with fair pay, are an established part of healthcare system.
Just as the MBS is for general practitioners.
Harmonising Scope
Across every corner of the nation, pharmacists will soon be able to initiate and resupply hormonal contraception.
They can already treat uncomplicated UTI’s.
For the first time, we have a federal programme complimenting the State and Territory based initiatives.
A year ago we had the Queensland model. Now we have the Queensland and Northern Territory model.
Each year more States and Territories are realising the benefit of full scope and coming on board.
The Opportunity
Becoming a full scope prescribing pharmacist is a small step with a big impact.
The conditions were chosen not on a whim, but because:
- they represent frequent GP visits
- preventable hospital admissions
- and a high volume of PBS prescriptions.
In Queensland, home to the first scope pilot, initial results from the 23 conditions will be available in later this year. Anecdotal feedback is positive. Patient outcomes are positive.
These are huge steps forward for our profession and for our patients.
We know that patients see the value in visiting a pharmacist when they can’t access a doctor.
The Challenge
Scope will never replace a pharmacist’s core clinical and cognitive service of dispensing.
But for pharmacists to dispense medication, there needs to be a script.
And with so many of our GP colleagues burdened under long waiting lists, burnt out and exhausted, there are not enough hours in the day for those scripts to be safely written.
Patients are delaying and deferring the healthcare they need because they can’t see a doctor.
Pharmacists have the expertise, training and opportunity to alleviate this struggle.
Our patients are relying on us to step up, and practice to our full scope.
Who are we to let them down?
Unleashing the expertise of the pharmacy sector will inject huge capacity into the primary health care system, for the benefit of all Australians.
Conclusion
Now, this doesn’t mean your Guild has stopped doing everything it was doing before.
Workforce, rents and cost of goods are top of mind for many of you. We hear you.
They are top of mind for us, too.
Your Guild continues to provide Industrial Relations advice and support through your local branches.
Your Guild has also secured free Pharmaceutical Society of Australian membership for our members to enhance your educational opportunities.
I am optimistic about the direction of community pharmacy, and the path we are walking together.
I am optimistic about our role in delivering healthcare for the future.
To ensure your core clinical function of dispensing is always valued, your Guild is here.7
For every community pharmacy that wants to seize the strategic opportunity of Full Scope, your Guild is here.
For every community pharmacist supporting patients struggling to afford their medicine, your Guild is here.
For each one of us in community pharmacy, your Guild is here.