Totally understand, I was referring to an urgent situation - but it’s certainly anecdotal, given it’s purely my personal experience. I had been to ED due to a sinus infection, the pain was excruciating, couldn’t eat or drink (vomiting from pain), so I couldn’t hold any pain killers down either. Followed up with my GP who was adamant I didn’t need a ENT referral, just antibiotics - and they’d agree with her too, so let’s not waste their time.

Thing is, I have allergic rhinitis, and have had a previous GP do the exact same thing many years prior, which lead to me having a blocked nose for 2 years before an ENT finally gave me steroids (was fine within a week). So, I put my foot down and refused the antibiotic prescription stating I needed a referral and mentioned the health insurance, boom, I was referred. I had surgery within 2 weeks, because the infection was bad. If I’d not been referred, the outcome may have been very different, had I been public, I may not have gotten for a long time and gotten very very sick.

Which I guess it what happens to people who don’t have insurance or don’t understand how to navigate the system well (I work in a health field and often see the impacts of health illiteracy), or who aren’t able to advocate for themselves - that’s where my main concerns lie. When it is urgent, and insurance is the key factor; not the normal circumstances where it’s warranted.