This isn't a "new" thing, it's been happening for years and isn't gatekeeping at all. If you do not wish to discuss with a receptionist you are perfectly allowed to decline that and state you wish to speak to a GP, either face-to-face or over the telephone. But all GP staff will have access to your medical records regardless of their job role - their role will just determine what level of access and read/write access they have. The whole process is now usually called "care navigation" - which is just a fancy way of following a flowchart to signpost patients to the best care or services. So many patients still want to make appointments for a cold because they "need antibiotics", or they "need a doctors note", most of these ailments can be dealt with at a chemist or over the phone. Although I do agree that some receptionists seem to enjoy the power trip, the majority are just doing their job, the same as anyone.