In this article, we critically discuss a Swedish hospital foodservice reform by putting foodservice in a historical and social context and analyzing a case, "the most flexible patient foodservice system in Sweden," by using Bacchi's what's the problem represented to be (WPR) approach. We show how hospital foodservice governance in Sweden has become more focused on the individual patient as a consumer. Our analysis points out how in political protocols and related policy materials freedom of choice, flexibility, and efficiency were articulated as drivers of change. Freedom of choice was argued to enhance quality, increase food intake, diminish demand for special diets and lower costs. This can be seen as empowering patients, but also shifting part of the responsibility of nutrition care and health over to individuals, whether they want it or not. Flexibility was seen as beneficial for patient logistics regarding medical treatment and argued to improve allocation of staff resources. Inefficiency was a characteristic attributed to the old system, while the reform was an opportunity to modernize and be more cost-efficient. The new organizational structures may lead to tensions between foodservice and healthcare. The changes, system flexibility and patient freedom of choice, are salient within a broader neoliberal discourse.
Keywords: WPR analysis; governmentality; hospital foodservice; patients as consumers; policy.