Beyond blame: Neoliberalism, responsibility and hospital appointments

Failed hospital appointments pose a persistent challenge to healthcare systems, disrupting care continuity and straining resources. In Denmark, institutional responses often emphasise patient responsibility, overlooking the structural and organisational factors that contribute to nonattendance. This PhD project reconceptualises failed appointments as an institutional phenomenon shaped by administrative routines, policy frameworks and communicative practices. Combining contemporary historical analysis with institutional ethnography, the study investigates how healthcare policies and local procedures in two hospitals in the Region of Southern Denmark respond to patient vulnerability. Drawing on theories of neoliberalism and moral agency, it examines how booking systems, digital communication and triage practices influence whether patients access care or are excluded from it. Fieldwork includes document analysis, observations and interviews with patients and professionals. The project seeks to uncover how blame and shame emerge in institutional encounters and how structural barriers such as bureaucratic complexity, rigid scheduling and poor communicative alignment undermine equal access. By shifting the focus from individual failure to systemic conditions, the study aims to inform more inclusive healthcare strategies and foster a shared sense of responsibility across the healthcare system.