‘It was a bad day’:Twomey’s going to war with Albanese,and he has no regrets

When members of the Pharmacy Guild appear in the public eye,they wear a Ben Casey,the official pharmacists’ uniform they receive at a white-coat ceremony when they graduate. When they represent the guild in private,they put on a blue and gold tie,a long-held tradition for members of what is sometimes referred to as“the most powerful lobby group you’ve never heard of”.

Trent Twomey,the guild’s national president,has often appeared around Parliament House wearing the coat donned by pharmacists behind the counter. “There’s a lot of symbolism,” he says. “I’m very big about,when I’m speaking as a clinician,you dress as such.”

But when he turns up at the Molto Italian restaurant on Canberra’s Kingston foreshore for our lunch,it is in a crisp white shirt and vest:the signature Ben Casey is nowhere to be seen.

I’ve asked him to lunch to understand the man creating a headache for the government by fronting a fierce campaign againstits policy to halve the price of common medicines for Australians.

The change will double the amount of medicine people can collect with each script from 30 to 60 days’ supply,creating a major saving for consumers,but pharmacies will take a haircut in the process.

Just hours after Health Minister Mark Butler made the announcement in April,Twomeywas standing at Parliament House in Canberra flanked by several local pharmacists — all wearing their white coats — and blasting the government for throwing their sector under the bus.

Twomey choked back tears as he said the Labor government “doesn’t give a shit” about businesses and told MPs to “get off your arse”. It’s not the first time his language has raised eyebrows. A few months’ earlier,he earned the ire of the doctors’ lobby group for mockingGPs who had allowed their businesses to be corporatised as “twits”.

But during our lunch,not only is the Ben Casey missing,Twomey the bomb thrower is AWOL,too. Instead,he is exceedingly obliging and well-mannered. It starts with a hug he receives from restaurant manager Luca Tosolini before we’ve even sat at the table. Twomey lives in Cairns,where he grew up,but he is a regular at Molto when he stays in Canberra for work,which is often.

Tosolini asks if we’d like anything to drink,and Twomey opts for a sparkling water. When I request tap water for myself,he changes his mind. “Oh,I’m happy to go tap,” he says. He rebuffs my insistence he should order whatever he likes — this masthead is paying,after all — and turns to the waiter:“I’ll go tap,too.”

There are a variety of cheeses and share plates on the menu,but Twomey says he’s satisfied with the fish of the day. “I tend to do the Paul Keating ‘don’t eat the bread’ thing.”

He explains:“A journo asked[Keating] how do you stay so thin when all you do is go to lunches and dinners? ‘Never eat the bread’.” A few minutes later,Tosolini brings a charcuterie plate and some olives with compliments from the kitchen. True to his word,Twomey doesn’t touch them.

Observing this restraint,I ask him if he saves his brash North Queensland demeanour for political effect. “Am I always going to be blunt? Yes ... Sometimes you need to be blunt to get cut through because you’re not getting cut through on an issue,” he says. Later,he adds:“I am a pharmacist from a working-class family and a regional location. If that offends the sensitive ears of,you know,private school bureaucrats in Canberra,well,I’m sorry.”

The 43-year-old is the eldest of four,and grew up in a single-parent household where his mum was a pharmacy assistant. The family lived with his grandparents for a while. Twomey cut his teeth at McDonald’s before getting a job at the local Terry White chemist during high school. When he left school in 1999 and had to choose a career,he stuck with pharmacy.

He got involved in politics early,as chair of the welfare committee at his local high school,and then as a delegate to the National Union of Students when he studied at James Cook University. He helped establish the university’s student pharmacy union and,eventually,became president of the National Australian Pharmacy Student Association. That’s how he met his wife,Georgina. “She was a Tasmanian pharmacy student[in Hobart] and we met in Perth at a student conference. She became president of the[association] a year after me,” he says.

If it sounds like Twomey had it all worked out from an early age,there’s evidence. I’ve brought with me a 2005 article from our archives,in which a 23-year-old Twomey was profiled as one of a “new breed of graduate pharmacists” determined to forge a modern career path. Freshly graduated from pharmacy and in the middle of a business degree,he said he wanted to own a part-share in a conglomerate of four or five pharmacies with his business partners. (His actual trajectory is not far from this ambition:Twomey and his wife are now partners in the Alive Pharmacy Group in North Queensland,and co-own 13 chemists.)

He laughs as he reads it. “What 23-year-old has it all worked out?” he says. I ask if he was always ambitious;Twomey says he was driven. Patience,however,is not something that comes naturally,he says.

Twomey is a Liberal National Party member (which he says he’s proud of,although he doesn’t volunteer that information up front) and has helped the election campaign of his local Coalition MP and close friend, Warren Entsch.

But Twomey says he has no intention of entering politics proper,despite rumours to the contrary. “I genuinely love being a pharmacist,” he tells me when I ask about speculation he will succeed Entsch in Leichhardt or run for the Senate.

Does this mean we will never see a Trent Twomey MP? “No. For the record. 100 per cent.”

He has plenty of politics on his plate,anyway,heading up a powerful lobby group during what has been described as a litmus test of the Pharmacy Guild’s political influence. It has long held sway in Canberra and is one of the biggest donors. Last year,it gave $577,565 to the major parties:$310,330 to Labor and $267,235 to the Coalition in the 2021-22 financial year.

Twomey brushes off questions about the guild’s power (“I think we are a fierce advocate for our members and our patients”) and praises its membership (“Many other peaks don’t have that grassroots motivation that we have. I think that is the point of difference”.) Nor does he have much concern around the issue of donations (“There’s a difference between access and influence. Donations do not buy you influence. People[who] think that,they don’t understand how the system works”.)

It’s around this point our meals arrive:a pan-fried crispy skin bonito with pea and mint purée,sautéed capsicum and purple carrots for Twomey,and wood-fired prawns with a side of green beans for me.

Our conversation turns to the task ahead of him:the guild’s campaign against 60-day dispensing rules which,by all accounts,is a popular policy among consumers. Twomey obviously disagrees. Not with the concept of cheaper medicine,for which he says he has been calling for longer than the government,but with this mode of delivery.

“The reality is this. The government’s own data set[says] this is an 18 per cent cut to remuneration. Now,what other sector,whether it’s a childcare centre,whether it’s a nursing home,whether it’s a general practice,could take an 18 per cent cut?”

Critics might call pharmacies rent-seekers,or point out they’re a protected species insulated from competition with strict ownership and location rules that prevent supermarkets encroaching on their turf and keep prices high for patients. To which Twomey says:“I think we need to look at the outcome. And the reality is,pharmacy is the most accessible piece of primary healthcare infrastructure.”

The government’s ownOffice of Impact Analysis has said small businesses particularly in rural and remote areas will shoulder the greatest impact from the government’s changes. But I suggest that the guild’s campaign,which has hammered in on medicine shortages,stockpiling and risks to patients,hasn’t sold its message effectively.

Twomey says it has. “It’s working,and it’s not going anywhere. It’s only going to turn up.” Community pharmacies are already putting posters of Prime Minister Anthony Albanese in their windows or encouraging their patients to complain to the government,but Twomey is not specific about what more is in the arsenal.

The chair and former chair of the Pharmaceutical Benefits Advisory Committeehave rebuked the guild’s claims about medicine shortages, saying the 60-day policy won’t change the quantity of medicines dispensed in any given year and can be adequately managed by the phased nature of the policy. Twomey fobs that off,claiming the independent body is in charge of clinical safety and has “no skill set in talking about medication shortages or availability”.

“I think we’re going to have a very real threat to the level of services that Australians have come to expect from their local community pharmacy. I think we will get longer GP waiting times. I think we will get more code yellows in bed ramping and hospitals and emergency departments,when they have to start picking up the slack that we’ve been shouldering.”

I tell him that sounds like scaremongering. “I think Australia’s community pharmacists are scared,” he says. Surely,his relationship with Butler is souring with this rhetoric. “Oh,well,it’s stretched,isn’t it?” he says.

We order coffees – a macchiato and short black – and Tosolini asks if we want sugar. “I’m sweet enough,” Twomey says. “It’s widely known.”

The guild is treading a delicate line between taking on the government over its prescription reforms and not completely burning bridges with it. “I still feel betrayed by the government because I told my membership that this government is someone that you can work with,” Twomey says. “I still hope that this is just a hiccup in what is going to be a good working relationship.”

It’s a very diplomatic rendering and certainly a far cry from the language he used in April when he said publicly that Butler and Labor “didn’t give a shit”.

But Twomey says hedoesn’t regret that press conference. He reveals more about that day,when he tearfully fronted up at Parliament House. “We lived with my grandfather for a big chunk of my childhood. He was put on a morphine drip the night before – palliative. And I received a phone call from my CEO to say the minister is making this announcement the next day. So I left his bedside in the hospital,and I got on a plane,and I flew to Canberra. And I missed him passing by two hours for this. I didn’t tell my staff that had happened because they had enough on their plate.”

He says his phone was lighting up with messages from pharmacy owners who feared going bankrupt and couldn’t get through to their MP. “So,yeah,it was a bad day.”

And for those who might say his tears were a performance? “I have nothing to prove. I don’t. All I can be is who I am,” he says.

As we wrap up with a complimentary shot of Limoncello – he will only drink if I drink,he says – I search for one last sign of his combative side by asking about the guild’s rival,the doctors’ lobby. “I have a lot of frustration with the leadership of GP lobby groups,but I have nothing but respect for GPs,” he says,refusing to bite.

I tell Twomey that,for someone with a reputation for being blunt,he has been very polite. “I am polite!” he says. “My grandmother would clip me around the ears,and so would my wife and so would my mother,if I went to a lunch and was anything but polite.”

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