I'm a gp receptionist so hard hat on. I can tell you about how our practice works.
We have around 6000 patients. Most days there are 4 to 6 doctors appointments available to book over the phone for emergencies. We are told to use them for under4's or things that sound like dire emergencies only so yes we are gatekeeping those appointments, we have no choice.
There are then around 10-15 same day appointments we can book with the clinician. These are booked if you ring up with anything from rashes, lumps, headaches, pains. The clinician will either treat you or get advice from the doctor who will then book you in with themselves.
Most appointments are done via the online form, these are not same day appointments. The form goes to Dr for triage who forwards it to us with the instruction of who to book in with, themselves, clinician, physio, nurse. We don't choose who you see, we can't book with the Dr if he has instructed another professional.
The rest of the Dr's appointments are taken up with follow ups and reviews, the Dr books these or instructs us to.
There are also a few telephone appointments, we use these if someone has rang and we can't fit them in anywhere else, Dr will ring and if he decides he needs to see them he'll bring them in.
So in short yes we are gatekeeping, no we don't want to be, we're stuck. Any yes we get shouted at, abused, threatened daily. Such fun.
But then there are lovely patients who know we're doing our best and we do really try to get you in with somebody.