Purpose: Governments are increasingly marketising human services in developed countries, with the aim of giving individuals more choice and control over the support they receive. Marketisation effectively transforms “clients” into “consumers” who are exposed to competitive market conditions and the marketing strategies of service organisations. However, the heterogeneity amongst citizens leaves some segments of populations more vulnerable within marketised systems. The purpose of this study is to examine the impact of the marketisation of human services on the value delivered to consumers of disability services. Given that the nature of disabilities can vary greatly, the study also examines the impact of the degree of disability on value creation and destruction for disability service consumers. Design/methodology/approach: Qualitative, individual-depth interviews were conducted with 35 participants: 17 were consumers of disability services (either because they have a disability or care for someone who does) and 18 were disability service providers (for example, managers of disability programmes). Findings: Factors that influence value creation and destruction include quality and turnover of staff, organisation and communication of service providers, ability to advocate effectively, level of funding and accessibility of services. Heterogeneity amongst consumers is also identified as a key factor affecting the creation and destruction of value. Originality/value: To the best of the authors’ knowledge, this is the first study to apply marketing techniques, such as market segmentation, to identify heterogeneity in relation to value creation and value destruction in the context of human services. It also considers the notion of consumer vulnerability, stemming from disability, as an important lens through which the outcomes of marketised human service systems can be evaluated.