All pink glitter, no gold: Pharmaceutical lobbyists are using women’s health to push their agenda
On the surface, easier access to contraceptives and UTI treatments seems like a win for women’s health. But the cost of frictionless, pharmacy-first healthcare is fragmented, flattened care, argues medical doctor Madison Booth.
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What if the chemist was your first stop for healthcare? You could swap the drudgery of booking a GP appointment for a walk-in with your local pharmacist.
With the direction the federal government is heading, it’s possible.
A March 2026 announcement confirmed the federal government will fund pharmacists to prescribe oral contraceptives for women starting January 2027 without GP involvement. They can also prescribe antibiotics for women with UTI symptoms.
Superficially, this seems like a win for women’s health: easy access to antibiotics for stinging urination; a quick trip to get on the pill. But beyond the explosive pink glitter of this move lies the Pharmacy Guild of Australia, a formidable beast of lobbying power.
The Guild represents community pharmacy owners. They contribute the bulk of political donations from the health sector. An eye-watering total of over $600,000 was donated last financial year, with $360,000 to the Labor party alone.
What is the Guild’s plan? By 2035, they want 80% of Australian community pharmacists to be prescribing. Their ultimate goal? For Australians to “think pharmacy first for healthcare.” Not until women test the waters first, of course.
Pharmacy Guild president Trent Twomey’s recent comments confirm this: “Empowering trained pharmacists to deliver more women’s health services means women can access the help they need sooner — and GPs can focus on more complex care. It’s a win for patients and a win for the health system.”
We need to understand the fanged wolf beneath the sheep’s clothing of this women’s health initiative. The Guild is using women and pharmacists as pawns in their power plan. The shimmer of a frictionless healthcare encounter is tempting. The expense is fragmented, flattened care. Not least because pharmacists can self-determine their prescribing competency with brief online modules.
The Guild’s strategy is to use UTIs and contraception as the entry into broader pharmacist prescribing. UTIs seem benign enough, and contraception doesn’t require diagnosing. Women lose here, as the 43-question algorithmic flowcharts followed by pharmacists lead to antibiotics without so much as a urine sample. Oral contraceptives are less effective than gold-standard long-acting reversible contraceptives (like implants and IUDs), so why prioritise them?
It’s also worth noting that any GP worth their salt will seize a UTI- or contraception-based encounter to discuss sexual health, cervical cancer screening, and screen for issues of mental health and domestic violence.
Ultimately, the Guild wants pharmacists prescribing for chronic diseases like hypertension, diabetes, and high cholesterol. It is a slippery, dangerous slope to siloed, sub-par care. The only ones who benefit are pharmacy owners and the Guild.
As a doctor, I imagine the practice of medicine as a multi-tentacled organism where the limbs of anatomy, physiology, pathology, microbiology, histology and pharmacology work harmoniously to achieve best patient outcomes.
Arriving at a diagnosis is not always easy. It certainly can’t be reduced to algorithmic questions preceded by a script. Without a physical examination, investigations (blood, urine and swabs), or imaging, the patient misses out.
There is an adage in medicine which goes, if you don’t put your finger in it, you put your foot in it, highlighting how easy it is to miss critical – sometimes life-threatening – issues by neglecting aspects of the diagnostic process. Women deserve better.
I am not devaluing pharmacists. We are teammates. Pharmacists are drug wizards, collating medication histories, highlighting prescribing errors, educating patients on how drugs work, when and how to take them, identifying adverse drug reactions, allergies, and more. Their scope is broad, their skills elite.
But I urge you to not think pharmacy-first when a health issue arises. The momentum of the Guild’s influence is fierce, and most pharmacists are motivated to expand their scope benevolently. But it fragments care, kills chances for holistic management, and supports pharmaceutical lobbyist dreams.
The person who prescribes your medication should not be the one who dispenses it. Your primary healthcare needs should not be sought in a retail environment. We must untangle our health from capitalist consumer culture as much as possible; a community pharmacy is no exception.
There is an alternate vision, my utopian (but possible) dream. Pharmacists attain prescribing competency degrees in cooperation with medical schools to bridge major gaps in clinical skills. This is already being developed. Online modules for prescribing are discarded.
The prescribing pharmacist does not operate out of a community pharmacy. Rather, they work collaboratively with GPs, nurses, and nurse practitioners in the same space. Add in physiotherapists, nutritionists and occupational therapists? Chef’s kiss.
Keep the multi-tentacled organism under one roof. Feed it, clothe it, invest in it. In this technofeudalist, AI-enmeshed world we live in, siloed care makes asking a chatbot for health advice alluring. It might feel more comprehensive, even empathetic. But if all your primary health providers are in one place, if each of them knows you in a unique way, that’s more holistic than a language learning model. And far superior to an isolated consult in a community pharmacy.
Our healthcare system is not perfect. Getting into a GP can be a struggle, and sometimes costly. But improvements are being made. An Australian Bureau of Statistics study found in the last financial year, more Australians were seeing GPs (83.4%), and 99% were able to see a GP when they needed to. We can do better and dream bigger for primary care. But we must prioritise it with our actions. Don’t let the glitter of the Guild fool you.
About the author
Madison Booth
Madison is a medical doctor with interests in rural generalist practice and emergency medicine. She is also author of the Substack amuse-booth.
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Thank you for this clarity, Dr Booth. It is also pernicious while research has shown some rural pharmacists reluctant to prescribe to women against their individual consciences. In cities, at least, urgent care is readily available for UTIs. This is where most of the profitable prescribing will happen, I fear.
I appreciate the points you make about quality of care but women’s health is not the same thing as the health of a woman. Pharmacy based supply of regular medication would mean, for some women, the difference between accessing medication or not. The cost, wait times, availability and accessibility of gps is prohibitive for teenagers and young unemployed or underemployed women, older women, working poor and homeless women, women in remote communities and more. In my long life I have never been asked about my experiences of violence and have been relentlessly pursued for screening only when govt programs demand it. I have experienced treatment by dozens of different doctors in rural, regional and metropolitan areas. On occasion I’ve had exceptional care from a gp; but I have more routinely felt treated as a widget.
Your utopian dream is laudable but the contest between doctors and pharmacists has prevailed for decades and in the meantime the health of women is routinely kicked to the kerb.
I wish you every success.