This paper discusses selfish routing in public service systems using a routing game framework. It motivates the work by reviewing previous literature on selfish behavior in queueing systems and the concept of price of anarchy. The main contributions are placing individual choice in public services like healthcare within a routing game model, analyzing the effect of demand and service worth on price of anarchy, and applying this to a case study of elective knee replacement services in Wales. Key findings include that price of anarchy increases with service worth up to a point and is highest when system capacity matches perceived service worth. The paper argues this framework could be useful for analyzing efficiency in other complex public systems.