A government think tank has released its final report on the country's social services and is urging major reform.
But the Productivity Commission is unable to offer specific solutions as to how the government should deal with the group that is most difficult to look after.
Every year, the country spends $34 billion on social services, more than 10 percent of the GDP.
Read today's final report into social services by the Productivity Commission (PDF, 4.3MB)
The commission recommends a move away from the current top-down approach, with more responsibility given to providers.
But it could not decide how to deal with the people with the most complex needs, instead suggesting that the government look at two possible solutions.
One option would be a standalone agency which oversees a client's case across a number of agencies.
The second would be to fund District Health Boards (DHBs) to be responsible for the country's most disadvantaged people.
It also recommends establishing a Ministerial Committee of Social Services, rather than an Office of Social Services, which had been recommended in its draft report. The ministerial committee would be responsible for reform of the sector.
The commission has defined social services as those including health care, social care, education and training, employment services and community services.
It has looked at agencies and services including Housing New Zealand, Work and Income, Whanau Ora, services for people with disabilities, and home care for the elderly.