Discount retailer Chemist Warehouse and 7-Eleven convenience stores are keen to enter the market, with the former arguing it could offer prices up to 60 per cent lower than pharmacies in regional towns. For Jane Mitchell, who co-owns the 24-hour Ascot Vale Pharmacy in Melbourne's inner north, the idea of retailers being able to sell prescription-only drugs goes against everything she's been taught about the safe provision of medicines. "I've never heard of anything more ridiculous in my life, you know, 7-Eleven are selling slurpees," she says. "We're not selling fruit and veg here; we're selling medication where advice needs to be given." Loading Replay Replay video Play video Play video She warns against a race to the bottom on price, saying deregulation would be "a slippery slope". But the guild says its members are highly trained and deeply connected to their communities. It warns corporate owners may put profits ahead of service and doctors owning chemists may have an incentive to prescribe medicines that aren't really needed.

Loading Chemist Warehouse uses a legal loophole to operate its discount chain of 300 stores - the law states no pharmacist can own more than five or six pharmacies in one state or territory - and has identified 60 regional towns where it would open outlets if location laws were relaxed. There is a Chemist Warehouse 260 metres away from Ascot Vale Pharmacy, where Mitchell has expanded services to offer flu vaccinations and diabetes education, along with a drug-replacement therapy program for patients being treated for opioid addiction. "Our pharmacists aren't monkeys just giving out medication. There's a whole lot more value to our service," she says. And they want to do a lot more.

Pharmacy Guild president George Tambassis, who runs a pharmacy in Melbourne, was in Canberra this week lobbying for pharmacists to be allowed to prescribe medications including travel vaccinations and the pill and treat complaints like erectile dysfunction. He wants the government to agree to fund a diabetes-screening program in chemists across Australia, after a trial in 363 pharmacies. I've never heard of anything more ridiculous in my life, you know, 7-Eleven are selling slurpees. The guild has a history of lobbying hard against any proposed changes it believes would disadvantage its members. It donates to both sides of politics and wields the threat of a highly organised election campaign through its network of chemists. Former prime minister John Howard in 2004 abandoned a plan to allow supermarkets to own pharmacies after receiving a threatening letter from the guild. The group's most recent push has ignited the ire of doctors, who warn patients will miss opportunities for unrecognised health problems to be detected if they see their GP less regularly. The guild says its members are not trying to be doctors - who have 14 years' training versus pharmacists' five - but want to work hand in hand with GPs and help ease pressure on the health system. "GPs have got huge waiting times and some practices have got no new patients allowed," Tambassis says.

"We're not reinventing the wheel here in Australia; there are ample international examples that have gone through this," he says. He points to the Canadian province of Alberta, where pharmacists are allowed to prescribe a broad range of medicines including antibiotics for urinary tract infections. Doctors warn this could result in undetected sexually transmitted infections, while the guild counters that patients would be screened through a questionnaire and sent to their GP if they were deemed at risk. Fredrik Hellqvist, from the Rural Pharmacy Network Australia lobby group, says country chemists just want to be paid for the services they are already performing for free. AMA president Tony Bartone says Australia has the best health outcomes in the world, while Canada is ranked ninth. He also questions the usefulness of pharmacy prescribing in regional Australia, which the guild says will help people in areas where GPs close early or come to town infrequently. "Accessing a pharmacy in smaller rural, and particularly remote, communities can be difficult," Bartone says. But Fredrik Hellqvist, from the Rural Pharmacy Network Australia lobby group, says country chemists just want to be paid for the services they are already performing for free, saying an increased workload is threatening their viability. "We are being expected to give a lot of advice in areas like wound care, skin care, sexual health, soft-tissue injuries and dental care, addictions and diet," he says.

Loading The guild wants the federal government to get rid of a rule that allows pharmacists to discount pensioners' PBS scripts by $1, something only discount chemists have been providing. Instead, the guild is lobbying for a $1 reduction in the legislated $6.50 price, called the "patient co-payment", a measure that would cost the federal budget $500 million over four years. Tambassis says for pensioners on five or more medications, the discount may help ensure they take all their pills. "They come into pharmacies and say: 'Which is the one I don't really need? Because I really can't afford four or five this month'." So why not support a previous government plan to allow patients to pick up two scripts at once? (The government shelved the idea before the election after the guild took out a full-page advertisment in The Australian.) The measure would halve the cost of more than 143 low-risk medications for pensioners, essentially making the second pack free, as the government would pay the pharmacist only once to dispense both packs. Tambassis says making patients come to the chemist each month means there is better oversight by their pharmacists and instead suggests pharmacists could prescribe the second pack to save the patient another visit to their doctor.

Hunt says he is "committed to leading early and inclusive negotiations" for the new agreement, which will be "patient centred" with "a key focus on consumer access to affordable medicines and community pharmacy services that deliver outcomes". He makes it clear the government "supports the model of pharmacists owing pharmacies". Health Minister Greg Hunt makes it clear the government "supports the model of pharmacists owing pharmacies". Credit:Lukas Coch Deregulation advocates point to countries such as the United States and United Kingdom, where big pharmacy chains CVS and Boots compete on price to deliver cheaper drugs. Boots, which has 2485 stores across the UK, announced in June it was closing 200 stores to cut costs while CVS announced dozens of closures in May. The guild says this confirms Australia's pharmacy rules are needed to ensure the right number of chemist shops operate in the places they're most needed so operators aren't forced to compete on price. Tambassis says it is no surprise Boots is closing stores because they're volume-based businesses and "on every corner". He says Australia's restrictions on the number of chemist shops in a suburb or town prevent "clustering" and ensure pharmacies open in areas of need, with most Australians living within 2.5 kilometres of their local chemist as a result.