How Consultants Push Public Hospitals Toward Private Deals
Management consultants exploit gaps in oversight to steer public organizations toward market-based solutions, a new study shows. Using a Swedish hospital deal as a case study, researchers found that consultants operating outside formal accountability structures can quietly dismantle democratic safeguards meant to protect public spending.
Originaltitel: Liminal market-shaping: Management consultants and disruptive institutional work in public organizations
<p>How are public organizations subjected to institutional work that reduces barriers to marketization within public decision-making while undermining procedural safeguards and democratic accountability? Drawing on a critical hermeneutic analysis, we examine the procurement of a multibillion hospital project in Sweden, where a public-private partnership gained legitimacy despite established safeguards for procedural fairness and public accountability that weighed against it. We show how liminality, as a state of being neither fully inside nor outside organizations, enables interventions in bureaucratic procedures without equivalent formal accountability. We conceptualize this as liminal market-shaping, expressed through management consultants' efforts to destabilize decision paths, moral foundations, and sanctioning mechanisms in public procurement. The study contributes to marketing theory by extending market-shaping research to public organizations, introducing liminal market-shaping as a form of disruptive institutional work, and conceptualizing public de-responsibilization to explain how marketization erodes rather than activates agency in markets and beyond, within democratic governance.</p>