Fund cuts are part of the problem granted.
But in my sector the care services bit, putting most services to tender. Improved outcomes and saved money massively.
Of course with tendering it went to 3 contenders.
1 charities, social enterprises etc (basically none profit making nice people)
2 Private companies that could emulate charities
3 Revamped council/nhs standards
A similar process could happen, if the will and oversight could be there.