Britain’s ageing population has created a “debt timebomb” that can only be defused through a combination of significant spending cuts, faster increases in the state pension age and ending universal free healthcare, according to a respected think-tank.

The Institute of Economic Affairs (IEA) warned that the Government would need to slash public spending by a quarter in order to get Britain’s debt mountain down to sustainable levels.

In a set of radical proposals, the IEA called on the Government to end “unhelpful” policies such as the “triple lock guarantee” that ensures the state pension increases by the higher of inflation, average earnings or a minimum of 2.5pc every year.

It also said charging for some NHS services would help to reduce demand.

The IEA calculated that Government spending cuts equivalent to 9.6pc of GDP – or £168bn per year in today’s money – were needed to reduce Britain’s debt-to-GDP ratio to 20pc by 2063. This is equivalent to cutting the health, welfare and pensions budgets in half, or overall spending by a quarter.

It explains how Andrew Lansley  accepts the need to trim his reformist sails – it goes on though to say “However, the Health Secretary makes clear that the changes are essential to cope with the “enormous financial pressures” generated by advances in medical science and a rapidly ageing population.

“He says that unless “we act now”, real terms health spending will ultimately double to £230 billion a year – or £7,000 a second – by 2030.

“This is something we simply cannot afford,” he says. His focus on the cost implications of allowing the NHS to continue as it is are part of the Coalition’s drive to help explain why the decision has been taken to shake up the service fundamentally.”

The demographic time-bomb of increasing numbers of the elderly is at its most acute in rural areas and this is where I anticipate some of the most significant pressures to occur in future.

I sometimes yearn for the 1980s – that might sound strange –  but in those days you could go to university without paying, have a reasonable pension, buy a house and go to a reasonable local school without all the current agony of choice and competition.