The Improvement Service’s submissions to the Christie Commission included this key paper: Making better places, making places better: the distribution of positive and negative outcomes in Scotland. It concentrates on demonstrating the degree of concentration within certain areas of ‘failure demand’ for public services driven by negative outcomes at a community level. It suggests that “the targeting of negative outcomes, and failure demand, would require a very localised, integrated and holistic engagement with these communities … the data is very unsupportive of the probability that any particular outcome can be improved in isolation from improving the overall circumstances and wellbeing of these communities”.

Some of the report is quite technical, but it then asks:“What does it mean in terms of people’s lives? What it means is people living in areas where children’s achievement in education is less than half the Scottish norm, and 25% of that achieved by children in the least deprived areas. It means people living in areas where 20%+ of the adult population are prescribed drugs for anxiety and depression; where in any year, 3 in every 10 adults will be emergency admitted to hospital and where life expectancy and healthy life expectancy are more than ten years less than the Scottish average. It means people living in areas where the rate of crime is 4 times the average for Scotland and 8 times the average for the least deprived areas in Scotland. All these negatives in people’s lives in these areas are statistically inter-related but, more importantly, practically interact in the daily lives of these communities creating ‘cycles’ of deprivation and affluence”.