How the public are likely to receive the report: Bobby Duffy

There is huge pride in the NHS and support for health services generally, with 77 per cent of people now saying that the British National Health Service is one of the best in the world, which is the highest we have measured and up from 50 per cent just in the late 2000s - 2007. In a recent international study that we did across 20 countries Britain actually comes second top in terms of rating of current access to good-quality health care; second only to Belgium; ahead of many other developed countries, but the fear for the future is also clear in people's opinions. We have got the highest sense of severe funding pressures that we have measured; in the most recent survey, 88 per cent of people saying that the NHS will face a severe funding problem in the future. People get the funding gap we will increasingly get.

We are also among the least optimistic about the future of health services - Britain down there is Just nine per cent of people thinking it is going to improve. Now you can see that we are not alone, particularly in developed countries, in thinking that they are going to have problems. We are not alone in facing these issues of rising health care costs.

In contrast, as you would expect there is a very different, much less clear picture of social care for the majority of the public- a massive issue, as we have heard, for those who need it but much lower of general experience of it It is not something that people think of in advance or particularly want to think of in advance. Six in 10 say they know nothing about it and when we ask who is preparing, only Just over a quarter of people say that they are preparing financially to even some extent for paying for social care services when they are older; very unlike health services but quite like lots of other issues. We do not quite know whether we want to be Scandinavian or American in lots of ways.

In terms of the recommendations, there is a lot you could say about individual elements of them but clearly the most prominent from a public opinion point of view is going to be how the changes are paid for. The majority always say that the NHS should be given more funding, so they are much more at that end of this sort of scale, where the NHS should be given more funding to continue to provide the services in the same way it does at the moment and the NHS should provide fewer services within the budget that it has at the moment If there was any service you would think would actually encourage people to support general tax rises, it would be the NHS, but in fact when you ask a decent question on this and a more sensitive question on this, you do only get around about a quarter of people saying that general rises in taxation is something they support as opposed to staying within its current budget, or cuts to other services or other measures; or people just don't know.

That is not what has been recommended in any case. It is much more sensitive, targeted changes to charges and taxes, with a clear inter-generational focus, where the better-off, older groups will be asked to pay in various ways but protecting the worse off among those older groups; partly because there is an increasing recognition that there is an issue with inter-generational fairness, at least in the sense that there is a severe challenge facing younger generations. When you ask this sort of question, 'When you reach your age do you think your children or today's youth will have a higher or lower quality of life than you, or about the same?' only 20 per cent of people now say it is going to be higher; over half of people say it is going to be worse. That is a real reversal over the last few years of greater optimism for youth, even in the early 2000s. It is partly down to the sheer weight of numbers. The 'baby-boomers' is a big generation but it is also to do with their turn-out their propensity to vote, so our model turn-out from 2010 is less than half of generation-wide voting but 76 per cent pre-war generation, over 70 per cent of 'baby-boomers' voted. When you work that through about the proportions of votes cast, you can see 'baby-boomers' are worth more than twice as much as generation Yin simple electoral terms.

First, we have to recognise that connections are stronger up and down the generational hierarchy than they are across generational hierarchies. We live in families; we do not tend to live in peer groups. So we worry about the impact on our families which is concern about them but it is also partly about whether it increases the burden on us. Secondly, on mindset, there is a really strong focus on recognising contribution among this particular generation of younger people. The current generation has a particular emphasis on personal responsibility and then rewarding people that take that personal responsibility. It is a different sort of cultural change.

Then finally there are misperceptions which include those things flagged earlier; that people just do not think they may need social care in later life, but there is still this very clear mental image of pensioner poverty among the general population. Getting a better, more honest, more specific conversation which I think the report does on how we are going to deal with this is a vital step forward.

Thank you.