Coolant has corrosion inhibitors that degrade over time, ‘tired’ coolant will allow the block to rust, which will result in sludge blocking the water passages and radiator, and in turn will reduce the efficiency if the cooling system and will cause the engine to overheat and HG damage to follow.
In addition, the coolant will lose its ability to prevent scaling - and the calcium deposits are both corrosive to light alloy (i.e. heads) as well as acting as insulating material and again causing overheating.
Also, it's not always the HG itself that fails - if the alloy around the waterways gets corroded, then water can 'jump' the HG while it is still intact (though not for long, as the blow-by from the combustion gasses will eventually burn the HG around the corroded area).
In short, no coolant change equals head gasket failure...
Traditionally, coolant needed to be changed every two years. Recently a new long-life coolant has been introduced, and it is coloured red to distinguish it from the older green type. On TIS, Vx say that the red coolant is 'for life' and that no coolant change is ever required other than in case of radiator or oil cooler replacement. However, on the actual container of the original Vx red coolant it says that is should be changed every five years...
If you ask me, for the cost of around £6 which is what 5L of original Vx red coolant cost, the coolant should be changed every year preferably in the spring.