One huge stumbling block to effective human services is the serious lack of accountablility. If a business is failing, first, it will be readily apparent at some point- profits will fall. And second, there is usually accountability- either the owner, or shareholders, or Board of Directors, will say, what is going on here.
This is different than what I have seen happen in human service organizations. First. it is much more difficult to determine "failure". Many programs do not even measure client success. Second, even if client success is measured, and found to be failing, there is little accountability. In a non-profit, there are no owners. There are no shareholders. There is usually a Board of Directors, but often they have very little vested interest in the success of the organization or its programs.
There actually ARE shareholders- taxpayers, clients and members of the community. But there has yet to be a strong movement driven by these people demanding accountability.
There seems to be a growth in interest in evidence based practice, which I see as a good sign.