In this article, we critically discuss a Swedish hospital foodservice reform by puttingfoodservice in a historical and social context and analyzing a case, “the most flexiblepatient foodservice system in Sweden,” by using Bacchi’s what’s the problem representedto be (WPR) approach. We show how hospital foodservice governance in Sweden hasbecome more focused on the individual patient as a consumer. Our analysis points outhow in political protocols and related policy materials freedom of choice, flexibility,and efficiency were articulated as drivers of change. Freedom of choice was argued toenhance 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 ofnutrition care and health over to individuals, whether they want it or not. Flexibilitywas seen as beneficial for patient logistics regarding medical treatment and argued toimprove allocation of staff resources. Inefficiency was a characteristic attributed tothe old system, while the reform was an opportunity to modernize and be more costefficient.The new organizational structures may lead to tensions between foodserviceand healthcare. The changes, system flexibility and patient freedom of choice, are salientwithin a broader neoliberal discourse.