Should average individuals have offshore accounts like the super elite?

Navigating the unfair care and tax system for seniors with neurodegenerative diseases.
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High Rate of Neurodegenerative Diseases

The UK faces a high rate of neurodegenerative diseases, impacting around 11 million people and contributing to 1 in 5 deaths, with 800,000 annual hospital admissions (Brain Research UK). Over 1 million individuals in the UK grapple with neurodegenerative diseases, including prevalent global conditions like Dementia (50 million) and Parkinson's Disease (7-8 million), alongside less common but impactful disorders like Progressive Multiple Sclerosis (PMS) and Motor Neuron Disease (MND) (MRC Clinical Trials Unit, University College London). The ageing global population has significantly increased the prevalence of brain disorders, with dementia, particularly Alzheimer's disease, being the leading cause (Interventional Systems Neuroscience, Imperial College London).

Parkinson's disease, affecting nearly 1 million individuals in the United States and over 6 million worldwide (Michael J Fox Foundation), is the fastest-growing neurological condition globally, with no current cure (Parkinson’s UK).

There is a  pressing need for social care reforms. Photo credit: Simon Forest, UnsplashThere is a  pressing need for social care reforms. Photo credit: Simon Forest, Unsplash
There is a pressing need for social care reforms. Photo credit: Simon Forest, Unsplash
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In the UK, around 153,000 people are affected, projected to rise to around 172,000 by 2030. Every hour, two new diagnoses occur, totaling 18,000 annually. The demographics reveal higher diagnoses in men aged 50-89. (Parkinson’s UK) White men with a family history, exposure to toxins, or head injuries are more prone to developing Parkinson's, typically manifesting between ages 50 and 60, with rare cases appearing before 40. (Seunggu Han, M.D. and Kimberly Holland) Despite the life-changing impact of a Parkinson's diagnosis, “most people find acceptance and quality of life after the initial adjustment period” (Michael J Fox Foundation).

A 2020 study revealed that rare neurological disorders, including Progressive Supranuclear Palsy (PSP) and CorticoBasal Degeneration (CBD), could be twice as widespread as previously estimated, potentially impacting up to 10,000 people in the UK, and they frequently experience delayed diagnoses, with 50% of PSP cases initially misdiagnosed as other neurodegenerative conditions (University College London).

The UK's Unfair Care System

Lack of Access to Care

The UK care system, particularly for those over 50, faces challenges like underfunding, service disparities, and unmet needs affecting 2.6 million individuals, with a 52% increase in care staff vacancies and extended waits hindering basic activities (Age UK).

Urgent support is required for unpaid caregivers, often older and in poor health. Age UK has advocated for increased social care funding to tackle workforce shortages and ensure reliable, timely care for older individuals (Age UK).

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Caring for individuals with advanced Parkinson's includes addressing practical and emotional challenges in end-of-life care. Young carers need extra support for their schooling and social life, and seeking a carer's assessment and local authority support are crucial for alleviating challenges and well-being (Parkinson’s UK).

Selling Homes to Pay for Care

Homeowners live in fear of having to sell their property to fund care fees in later life and see their wealth and any inheritance ravaged as a result” (The Daily Express).

The UK's unfair elderly care system, particularly affecting those with neurodegenerative diseases like Parkinson's, imposes a heavy financial burden disproportionately on the working and middle classes. The annual cost of living in care homes rose by 9.6% to £41,600 in 2023. The situation prompts considerations like selling homes, downsizing, annuities, and equity release (The Telegraph).

“Care fees have been steadily rising for years, but now soaring energy bills and food prices have pushed many providers to breaking point...self-funders, who pay for their own care, will bear the brunt of these surging fees. Even the most fastidious of savers are at risk of seeing their cash wiped out. . .recent figures put an estimated 137,480 people having to pay the eye-watering cost of care” (The Telegraph).

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The rising costs are outpacing inflation, posing challenges for individuals, while varying life expectancies and care home closures further strain available beds (Financial Times). With the property market freeze “pushing families struggling to pay care fees to breaking point. Families are unable to sell their relative's homes to cover their care fees and risk being dragged into costly financial schemes” (The Telegraph).

The split between self-funded and government-supported care exacerbates financial strains, with delays in the proposed cap on social care costs, once hailed as a beacon of hope, now facing delays and scepticism, leaving families in limbo.

In 2021, Prime Minister Boris Johnson proposed an £86,000 cap on social care costs in England to prevent forced home sales. The existing system sets a savings threshold of £23,250 for council-funded residential care, prompting discussions on deferred-payment agreements (DPAs) as a strategy to avoid forced home sales (BBC). In 2023, Prime Minister Rishi Sunak faced criticism for delaying the £86,000 cap initially set for October 2025 (Daily Mirror), and discussions around the cap have faded from UK political discourse as of September 2023 (Financial Times).

A 2023 study found that 75% of individuals aged 45 and above fear selling their homes for future care fees. Just 25% are aware that selling homes for care is not mandatory, according to retirement specialist Just Group. Limited alternatives and a complex care funding system deter future planning, as many are unaware of potential care costs. Self-funders may face annual residential care fees exceeding £50,000. Councils offer deferred payment agreements (DPAs) as an alternative, but they are underutilised and depleting inheritances. Urgent reforms, including home value exemptions and revised capital limits, are needed to address these issues (The Daily Express).

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“We need to see social care as an investment not a cost. Other countries have found big answers to managing ageing populations and it’s time Britain did, too” (Financial Times).

Advocates are calling for a transformative approach in the UK, inspired by successful social care models in the Netherlands, Australia, Germany, and Japan, emphasising viewing social care as an investment, and urging cutting red tape and fair pay for care workers. They propose implementing a comprehensive strategy akin to Japan and Germany, involving a national dialogue on universal contributions and support tied to physical assessments. As the UK's emphasis is on funding without addressing holistic well-being, demonstrating a lack of social solidarity. (Financial Times). The alternative of home care and potential financial assistance is a cost-effective option (Home Owners Alliance).

Within this labyrinth of financial strain, the looming prospect of selling homes to cover care fees, coupled with inheritance tax inconsistencies, exacerbate the existing injustices. The stark contrast between the super elite who routinely exploit tax loopholes within a system lobbied to their advantage, while the average middle and working class find themselves compelled to sell properties for care, highlighting the inequality and rendering the process of ageing with neurodegenerative diseases like Parkinson's an expensive endeavour.

Within this labyrinth of financial strain and inheritance tax disparities, the stark contrast between the super-elite routinely exploiting inheritance tax loopholes within a system lobbied to their advantage, while the average middle and working class find themselves compelled to sell properties for care, exacerbates inequality, injustice, and renders ageing with neurodegenerative diseases like Parkinson's a expensive endeavour.

Unfair Inheritance Tax

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Grieving families paid a record £7.1 billion in inheritance tax during the 2022-23 fiscal year, amounting to approximately £150 million per week (The Telegraph).

“Inheritance tax is a greater injustice in Britain than anywhere else. Deeply unpopular tax at an unusually high rate compared to other advanced nations” (The Telegraph). High care home costs force families to sell properties to afford care. After a family member's death, they face steep inheritance taxes on already taxed assets.

Some British political commentators may believe they are championing meritocracy for the common good. However, despite their intention to target the super elite, the operational reality of the tax system enables the ultra-wealthy to exploit loopholes, escaping inheritance tax burdens that disproportionately impact the middle class.

Notably, Margaret Thatcher's use of an offshore trust to circumvent inheritance tax, which continues more than ten years after her death, underscores the difficulties and disparities inherent in the existing inheritance tax framework.

Margaret Thatcher's Legacy and Luxury

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The irony becomes glaring when considering figures such as Margaret Thatcher, who despite introducing the law in 1984, managed to sidestep the inheritance tax by registering her Belgravia house in an offshore trust, saving millions.

End of life care at The Ritz

“Former PM died amid Ritz luxury paid for by owners Barclay brothers” (The Guardian).

Margaret Thatcher spent her final months at The Ritz, owned by the Barclay brothers, at a cost of up to £3,660 per night. The luxurious suite, adorned with 24-carat gold leaf and antique Louis XVI furnishings (Daily Mail).

She opted for the luxurious five-star establishment over her Belgravia townhouse due to the convenience it offered after bladder surgery. The Ritz served as her residence until her fatal stroke (The Guardian). While her stay at The Ritz was a privilege, it highlights the contrast with the circumstances of ordinary elderly citizens.

£8 million ceremonial funeral

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“Honoured with a funeral of a scale not accorded to a former prime minister since the lavish spectacle of Winston Churchill's state funeral half a century ago – and much of the cost...to be borne by the taxpayer” (The Guardian).

Thatcher's ceremonial funeral, with a price tag of around £8 million (Daily Mail), saw the government and her estate sharing the costs. (The Guardian) The event at St Paul's Cathedral, attended by the Queen and the Duke of Edinburgh (Daily Mail), featured a grand procession reminiscent of Winston Churchill's state funeral, including a gun carriage, military procession, and service at St Paul's Cathedral. The timing of the funeral coincided with debates at St Paul's on "the City and the common good," offering an ironic backdrop given Thatcher's government's deregulation of the City (The Guardian).

Despite being rewarded, honoured and praised for neo-liberal deregulation and policies, fostering a "greed is good'' and “profit over people'' culture, which widened the wealth gap over the last four decades in favour of the top 1%, Thatcher's legacy also brought about substantial economic decline in the UK beyond London. This decline since the 1980s, notably diminished industries such as steel, textiles, and manufacturing.

Estate registered offshore

Despite her lavish residence at The Ritz, Margaret Thatcher's estate details, including her Belgravia property, remain undisclosed. The 73 Chester Square property, registered in a British Virgin Islands tax haven, potentially enabled her estate to avoid millions in inheritance tax (The Guardian).

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Purchased for £2.4 million in 2006 by Bakeland Property Company Ltd, speculation arose about financing from one of Thatcher's affluent associates. Despite her philanthropy, the financial intricacies of her estate remain veiled in secrecy (The Guardian).

Listed for sale at £30 million three years after Thatcher’s passing (Financial Times), the estate successfully evaded substantial tax payments by being registered to an offshore trust, distributing assets of £4.7 million and a £12.5 million house to her descendants, and avoided the typical 40 percent inheritance tax by being registered to an offshore trust. The property's ownership by Bakeland Property Ltd in the British Virgin Islands allows it to persist posthumously and continue avoiding inheritance tax obligations (IWC Probate Services).

Barclay Brothers and Tax Exile Accusations

The Barclay brothers, owners of The Ritz, faced accusations of being tax exiles as they resided in Monaco while operating businesses from a UK office. An investigation by BBC's Panorama in December 2012 revealed that The Ritz Hotel, owned by the brothers, had legally claimed reliefs, leading to no corporation tax payments in the UK for 17 years. Frederick Barclay cited health reasons for living abroad when questioned about being a tax exile (The Guardian).

The brothers, who hosted Margaret Thatcher for free, were themselves accused of tax evasion, suggesting a widespread practice among the ultra-wealthy. These revelations underscore broader issues in the tax practices of the super-rich, contributing to the perception of an unfair and exploitable inheritance tax system.

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“The true spirit of Thatcherism was a simple combination: free-market thinking, nationalism, self-reliance and “a dash of populism” (The Economist). So, it’s clearly one rule for the public, another for the super-elite.

So, what next?

The question arises: should the average person resort to offshore accounts and trusts in the Caribbean, until a fairer and regulated system is established?

The current situation raises major concerns about the fairness of regulations and equity in the current property rights, care, and tax system. This is evident in the contrast between privileged figures like Thatcher and regular individuals dealing with high care costs and inheritance taxes. It underscores the pressing requirement for reforms in the care and inheritance tax system to establish a more just system and prevent the super-elite from effortlessly sidestepping it.

These challenges intensify for individuals coping with Parkinson's, where families grapple with care complexities, tax systems, and the pressing need for home modifications to aid in managing and caring for individuals facing difficulties associated with neurodegenerative diseases.

Understanding Parkinson’s Disease

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Neurodegenerative diseases like Parkinson's, Huntington's, ALS, and all forms of dementia, leads to gradual brain deterioration, causing personality changes, confusion, and tissue destruction (Lauren Reed-Guy and Nancy Hammond, M.D.), influenced by factors such as ageing, lifestyle, genetics, viruses, and toxins (NHS University Hospital Sussex).

Causes

The exact cause of Parkinson's disease is unknown, emphasising the need to understand complex factors such as genetics, environment, and ageing, where genetic research suggests a 30% risk from causal genes. With cases expected to double by 2040, there is an urgent need for effective treatments and improved quality of life for those affected (Michael J Fox Foundation).

Symptoms

“Parkinson's disease symptoms are different for different people. Some are hard for even doctors to detect. Others are obvious even to an untrained eye” (Michael J Fox Foundation).

Motor symptoms involve stiffness, slowness, and tremor, with variable tremor presence. As the disease progresses, difficulties in walking, balance, and coordination emerge. Non-motor symptoms include autonomic dysfunction, mood and cognitive changes, and other physical alterations. The severity of symptoms varies, emphasising the need for timely intervention and accurate diagnosis through consultation with a movement disorder specialist (Michael J Fox Foundation).

Treatment and Therapies

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Treatment involves a multifaceted approach, combining lifestyle adjustments, medications (levodopa, dopamine agonists, anticholinergics), and therapies addressing both motor and non-motor symptoms (Seunggu Han, M.D. and Kimberly Holland).

Current therapies focus on alleviating motor symptoms like tremor, stiffness, and slowness, as well as non-motor symptoms such as constipation, dementia, depression, hallucinations, pain, sexual dysfunction, and sleep problems. Surgical options like deep brain stimulation and focused ultrasound can offer symptom management (Michael J Fox Foundation).

Existing Parkinson's therapies provide only partial relief, prompting an urgent need for enhanced treatments to improve quality of life and impede disease progression, with tailored care guided by movement disorder specialists, incorporating exercise, lifestyle adjustments, and personalised decision-making (Michael J Fox Foundation).

Innovative New Research

Imperial College London is spearheading groundbreaking Parkinson's research, including initiatives like the Parkinson's UK Brain Bank, £250,000 surgical implant trials with Imperial College Healthcare NHS Trust to improve movement in advanced Parkinson's patients, and a £1.63 million grant for molecular research and early diagnosis biosensor development (Imperial College London).

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Additionally, new developments which have demonstrated potential in alleviating advanced Parkinson's symptoms. Such as a spinal implant developed by a Swiss team, which is undergoing additional clinical trials (The Guardian), and an $80 smart spoon invented by 17-year-old schoolboy Aarrav Anil from Bengaluru, to mitigate hand tremors and offer a cost-effective alternative for hospitals (The Guardian).

Considering the diverse progression of neurodegenerative conditions like Parkinson's, it's vital for individuals ageing with nerve diseases to take essential steps, such as making modifications to their homes.

So, what can you do at home?

A Parkinson’s Diet

A tailored diet for Parkinson's can aid in managing symptoms and potentially slowing disease progression by addressing reduced dopamine levels in the brain.

Consuming antioxidant-rich foods can potentially improve symptoms, such as nuts, berries, and nightshade vegetables, as well as incorporating levodopa-containing fava beans and omega-3 fatty acids from salmon, oysters, flaxseed, and specific beans. While avoiding dairy and saturated fats can help lower the risk of Parkinson's progression (Seunggu Han, M.D. and Kimberly Holland).

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Six Home Safety Tips for Individuals Neurodegenerative Diseases

Here are six essential home safety tips for individuals facing neurodegenerative diseases, such as Parkinson's, recommended by the experts from Premier Care in Bathing.

1. Personalised Guidance: Consult doctors and occupational therapists for tailored advice.

2. Communication Accessibility: Use cordless phones and store emergency contacts on handsets.

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3. Fire Safety: Address hazards, remove electric blankets, and regularly check smoke detectors.

4. Enhance Mobility: Improve movement with grab bars, ramps, sliding boards, built-up utensils, reach devices, and electric mattresses. Explore secure stairlift options for safe floor-to-floor navigation.

5. An Accessible Bathroom: Modify bathrooms with handlebars, ramps, and disability adaptations, considering wet rooms, walk-in showers, and walk-in baths for safety.

6. Home Comfort: Arrange furniture for comfort, use armrests, manage cords, and consider motion-activated lights.

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In conclusion, individuals with neurodegenerative diseases in the UK confront systemic challenges, financial hardships, and inadequate care support, necessitating urgent advocacy and improved resources.

The inherent unfairness in the elderly care system, particularly for Parkinson's patients, places an unjust burden on the working and middle classes, amplified by the indefinite postponement of social care caps. This postponement accentuates a stark contrast between the privileged super elite and the average person, leading to high care costs, home selling for care, and facing inheritance taxes, prompting concerns about fairness in property rights and the tax system. The betrayal felt by older citizens due to social care funding inadequacies and the indefinite cap postponement underscores the pressing need for social care reforms, as echoed by The Daily Mirror's campaign for "Fair Care For All" (Daily Mirror).

The impact on young carers underscores the need for an equitable care framework, with independent financial advisers (Home Owners Alliance) and the NHS RightCare Progressive Neurological Conditions Toolkit (NHS England) playing crucial roles in promoting proactive financial planning and enhancing care standards.

This story has been researched by Premier Care in Bathing. For any concerns about your health, please first contact your GP.