This report shows that population ageing is no longer a problem for the distant future. Between 2011 and 2016, the number of people aged 65 and over will increase by 1,400,000 while the working age population below 50 will decrease. Population ageing will continue so that the number of workers for every person over 65 will fall from 3.9 in 2011, to 3.2 in 2021, and then to 2.5 in 2041. The real challenge is to change policy on the big spending items of pensions, pensioner benefits and the NHS. The Government must reverse the decision to increase the state pension in line with earnings rather than prices. It should drop plans for a single tier pension which has been estimated to cost an additional £11 billion per year by the Department of Work and Pensions. It should rethink its commitment to pay benefits such as the Winter Fuel Allowance to all pensioners, at an annual cost of nearly £3 billion, when almost 90 per cent of the payments are unnecessary. And it should look urgently at ways for citizens to pay privately towards the cost of the NHS. People in the UK make amongst the smallest private contributions to the costs of healthcare of any major country.