A reflection prompted by the latest figures on delayed discharge,  and by what we see every day in social care.

First things first: this is a UK-wide issue, not a Scottish anomaly. Across the UK, hospitals are holding people who are clinically ready to leave because the right care simply isn’t available elsewhere. In Scotland alone, that cost reached £440m last year, with hundreds of thousands of days spent in beds that were the worst possible place to recover or retain independence.

In Scotland, we are at least fortunate that the National Care Home Contract funds providers consistently and equitably. That matters. But we also have to be honest: the weekly rate available through the NCHC still falls well short of the true cost of good care.

At Erskine, as a proud Veterans charity, we choose to cover that gap. We spend roughly twice what we are paid, per resident, to ensure Veterans enjoy dignity, safe staffing levels, skilled nurses, allied health support, and environments that respect the individual. We can do that only because Scotland supports our mission and donates generously to maintain Erskine standards.

But here’s the question that keeps nagging at me: don’t all elderly and vulnerable citizens – once defended by those very Veterans – deserve the same standards?

That’s the moral argument. But there are also hard clinical and financial ones.

Care providers that cannot fundraise are forced to operate at minimum funded staffing levels. They make constant trade-offs between what would genuinely help someone live well and what is simply essential to keep the lights on. Retaining staff at resilient levels becomes harder, vacancies rise – and care home bedrooms lie empty, not for lack of need, but for lack of staff.

The result? People remain in hospital, deteriorating. Costs escalate. Dignity erodes.

So here’s the strategic thought experiment. If even half of that £440m currently being spent on delayed discharge had been deliberately and strategically redirected into additional social care funding for – care homes and home care – wouldn't staffing have approached stabilisation, capacity been restored, and people better supported in the right place at the right time?

Citizens would have stayed out of hospital – or left it quickly. Independence would have been preserved. Dignity would have been protected. And the system would have spent less, not more, and operated more swiftly and efficiently.

Extra funding for social care isn’t a soft or sentimental choice. It’s the strategic choice. The sustainable choice. The civilised choice. And, above all, the humane choice.

Dignity has a price. But pretending otherwise is costing us far more.