Pharmacy ownership rules can destroy access to rural healthcare, so how do we fix it?
July 22, 2026by Dr Ramya Raman
In this article...
Research published in the Australian Journal of Rural Health, published in March 2026, identified significant gaps in access to community pharmacies across Australia. Researchers Michael Leach and Emily Griffin examined more than 6,000 pharmacies and found low pharmacy density in remote communities, regional areas and parts of outer Melbourne and Perth.
As a GP and candidate for RACGP President, I am writing about this because the pharmacy lobby is actively campaigning for pharmacists to diagnose and prescribe for an expanding range of conditions. It promotes pharmacy scope expansion as a solution to gaps in healthcare access and as an alternative to care currently provided through general practice.
General practice and pharmacy face many of the same workforce challenges. Both can struggle to attract and retain clinicians in rural communities, rapidly growing outer suburbs and other underserved areas. Limited opening hours, workforce shortages and long travel distances can affect access to both services.
However, pharmacy faces an additional barrier created by its own regulatory structure. Restrictive ownership and location rules limit who can establish a pharmacy and where it can operate. If accessibility is being used to justify expanding pharmacy’s clinical scope, these restrictions must also be examined.
Pharmacy ownership rules can work against access
Under state and territory laws, ownership of community pharmacies is generally restricted to registered pharmacists, with limited exceptions. Federal Pharmacy Location Rules also determine where new PBS-approved pharmacies can open and where existing pharmacies can relocate.
These rules mean that opening a pharmacy in an underserved community requires more than finding a pharmacist willing to work there. That pharmacist must also be prepared and financially able to establish or purchase the business, lease premises, employ staff, buy stock and carry the commercial risk.
A pharmacist may be willing to accept a secure and well-supported position in a rural town or growing outer suburb without wanting to take out a substantial loan and become a business owner. Requiring the pharmacist providing the service to also finance and own the business narrows the options available to communities already struggling to attract healthcare professionals.
The workforce challenge is difficult enough. Ownership restrictions make it harder by reducing the number of people and organisations able to invest in establishing a pharmacy service.
Allow alternative ownership where access is poor
Governments should prioritise relaxing ownership restrictions in communities with clearly identified pharmacy accessibility gaps.
A GP or general practice, for example, could be permitted to own a pharmacy attached to or located near the practice. The practice could provide the premises, capital, administration and business support while employing a registered pharmacist to manage the pharmacy and deliver its professional services.
The pharmacist would remain responsible for dispensing, medicines advice, patient safety and clinical decisions within the pharmacy. The GP owner would not be permitted to direct the pharmacist’s professional judgement. I recognise that some believe GPs should also be permitted to dispense medicines in certain circumstances, and I am open to hearing those perspectives.
There is a clear opportunity for GP owners and pharmacists to build practical synergies, particularly in communities where neither service is easy to sustain independently. A general practice may already have suitable premises, reception and administrative staff, technology, utilities and established relationships with the local community.
Sharing this infrastructure could lower the cost of establishing a pharmacy and provide a more secure employment model for the pharmacist. It could also support longer opening hours, more reliable medicine access and closer communication between GPs and pharmacists when patients move between prescribing and dispensing services.
This would not make the pharmacist an extension of the general practice. The pharmacist would remain professionally independent and accountable for pharmacy care. It would simply allow the two services to share infrastructure and work alongside each other where doing so improves access for the community.
Alternative owners could also include Aboriginal Community Controlled Health Organisations, community cooperatives, local councils, rural health services and not-for-profit organisations. Many already have the infrastructure, workforce support and local connections needed to sustain a pharmacy that may not survive as a conventional standalone business.
Business ownership and professional responsibility do not need to sit with the same person. An owner can provide the investment and infrastructure while a registered pharmacist retains full control over pharmacy practice.
Maintain professional independence
Patients must remain free to take their prescriptions to any pharmacy. GPs should not receive financial incentives based on the number or type of medicines dispensed, and pharmacists must retain the authority to question prescriptions, contact prescribers and refuse to dispense when clinically appropriate.
Ownership arrangements should be transparent, with safeguards separating prescribing decisions from pharmacy revenue. Regulators could monitor prescribing and dispensing patterns and investigate unusual activity where required.
These protections can be delivered through registration, accreditation and clinical governance. Across healthcare, clinicians routinely work in businesses they do not personally own while remaining accountable for their professional decisions.
Some communities will still need direct support
Alternative ownership will not solve every accessibility gap. Some communities are too small or dispersed to sustain a pharmacy through prescription and retail income alone.
The ABC reported that a pharmacy on the Tiwi Islands closed despite substantial government funding because it was not commercially viable. People in communities without a local pharmacy may have to travel long distances, receive medicines by post or rely on limited arrangements through local health services.
These locations may require targeted subsidies, pharmacist workforce incentives, locum support, mobile services and reliable medicine delivery. Ownership reform would increase the range of organisations able to establish a pharmacy, while direct funding would support communities where the market alone cannot sustain one.
Apply the accessibility argument consistently
Pharmacists are important members of the healthcare team, but expanded scope should not be presented as the solution to gaps in general practice while restrictions within the pharmacy sector continue to limit access to pharmacies themselves.
The same workforce shortages affecting general practice also affect pharmacy. The difference is that pharmacy ownership restrictions add another obstacle by limiting who can invest, establish a service and employ the pharmacists who may be willing to work there.
If the pharmacy lobby argues that community pharmacy is accessible enough to replace millions of GP consultations, it must also be prepared to examine the ownership and location rules that prevent alternative providers from opening pharmacies where communities need them.
GP owners, Aboriginal health services, local organisations and community cooperatives should be able to invest in pharmacy services where access is poor, provided registered pharmacists retain professional authority.
Pharmacy regulation should protect patients and support safe access to medicines. It should not protect an ownership structure at the expense of communities that remain without adequate pharmacy services.
