At my previous surgery in camberwell, the group of receptionists would stand around chatting with a queue formed in front of them. If you timidly attempted an "excuse me" they would mace you. There were some rough types attending the surgery, but if you politely spoke to them in a gentle voice they'd have a security guard rugby tackle you to the ground then continue talking about who got off with who at the club last night, to a chorus of "is it".