from the Power Index .....

Kos Sclavos is the hot-headed pharmacist from Brisbane who leads the nation's most feared and effective lobby group: the Pharmacy Guild of Australia. His supporters laud him as a "colossus"; his critics accuse him of stifling competition, depriving patients of discounted medicines and putting pharmacists' profits ahead of the community's health.

Unlike Heather Ridout, Sclavos' influence doesn't cover a broad range of issues - and he's certainly not as well-liked. But if you're looking for power that's concentrated, power that's embedded in our political system and power that's wielded through intimidation, not just persuasion, then Kos is your man.

"They're an aggressive lobbying machine," says Chris Walton from the Pharmacy Coalition for Health Reform. "They have a bullying approach. There's always been a fear that if they ran a campaign they could bring a government down."

Steve Hambleton, President of the Australian Medical Association, says, "They've been one of the most influential lobby groups ever seen."

For most lobbyists, just getting access to government can be a struggle. But not for Kos and his mates at the Guild: their privileged status is enshrined in the National Health Act. Every five years, away from the prying eyes of the media, the government and the Guild negotiate a deal to compensate pharmacy owners for distributing PBS medicines. Last year's Community Pharmacy Agreement topped $15 billion.

These clandestine deals have ensured that pharmacy remains one of the nation's most protected industries: chemists face no competition from supermarkets and new entrants are banned from opening a store within 1.5km of an existing business.

"They've managed to entrench this model of pharmacy that no one even questions," says Jennifer Doggett, a health policy analyst at the Centre for Policy Development.

"Why aren't there pharmacists in supermarkets? Why aren't there home delivery pharmacists? People don't even ask these questions because of the restrictions the Pharmacy Guild has achieved.

"There's no public health reason for it - it's just about restricting supply."

The government, of course, could amend the legislation to cut the Guild out - but this would risk a major backlash by pharmacy owners in key marginal seats. Most Australians see their pharmacist every year, and pharmacy is regularly ranked as one of our most trusted professions. This gives the chemists real clout in Canberra.

At the top of this very powerful organisation sits a very powerful man. Kos Sclavos, who started his career as a pharmacist in Ipswich, and had run the Guild's Queensland Branch and the Australian Institute of Pharmacy Management before taking over as the Guild's national president six years ago.

Sclavos was the only lobbyist in our Top Ten who declined The Power Index's request for an interview. "One of the secrets of effective lobbying is not to talk about it too much in public," said Greg Turnbull, the Guild's communications officer and a former adviser to Paul Keating and Kim Beazley.

Those who know Sclavos describe him as "frenetic", "savvy" and a workaholic with an "encyclopaedic" knowledge of pharmacy.

"He has a huge amount of energy for a guy who's carrying a fair bit of weight," says John Bronger, Sclavos' predecessor as Guild national president. "I've seen correspondence from him sent at three or four o'clock in the morning...it was always obvious that he had ambition and ability."

He commands something akin to a cult of personality in the profession.

"He's the showman, he's the pied piper, he's the white knight," says a pharmacy insider. "He is the guild."

Sclavos is also renowned for his fiery temper and a willingness to play hardball to get what he wants.

"He will get on the phone and rant and rave," says a former Pharmacy Guild heavyweight. "Kos has frozen people out; he doesn't bring people into the tent."

Federal Queensland MP Andrew Laming, a former orthopaedic surgeon, discovered this back in 2005 when he penned an opinion article arguing for generic drugs to be made cheaper under the PBS. In response, Sclavos sent out a letter to chemists in Laming's electorate warning that, "if your pharmacy can't afford to lose $100,000 plus from the bottom line then you need to start doing something about this. Your patients need to be informed that Dr Laming is trying to close community pharmacies".

But, as Kevin Rudd learned, power doesn't last forever - especially when your abrasive style has put so many people offside. Recent controversies have damaged the Guild's image and, though the government is yet to buckle, Sclavos' enemies can smell blood in the water.

"Their halo is well dinted," says pharmacy reform advocate Chris Walton. "I think they're in deep trouble."

Two months ago the Guild struck a deal with Blackmores to offer vitamins dietary supplements to any patients purchasing antibiotics, blood pressure and cholesterol drugs. After howls of outrage from doctors and consumer advocates, the so-called "Coke and fries" deal was abandoned within weeks - a major embarrassment for Sclavos.

Only last week, The Greens announced they will push for a Senate inquiry into the Community Pharmacy Agreement to determine if taxpayers are getting value for money.

The managers of Chemist Warehouse, which runs 200 discount chemists, have also claimed that location rules are blocking them from establishing 40 outlets offering medicines at prices below conventional pharmacies.

Health Minister Nicola Roxon says Labor won't scrap the current agreement, which started mid-last year, but she does want consumers and other health groups to have more input when the next deal is made in four years time.

Whether Sclavos remains in power then remains to be seen. The Guild's constitution was changed during his first term to limit presidents to three consecutive terms, but, luckily for him, the changes weren't retrospective: he can stand again for re-election in 2014 if he chooses.

Until then, he'll keep ruling as he sees fit.

"You have your way, I have my way," he said, quoting Friedrich Nietzsche, in a speech three years ago.

"As for the right way, the correct way, and the only way, it does not exist."

http://www.thepowerindex.com.au/lobbyists/kos-sclavos