Ian Butler and Heather Payne present findings from a local study of the form and practice of statutory medical examinations for children looked after by the local authority. They report that only a quarter of children attend such medical examinations and that the quality of these medical contacts is questionable. The paper discusses these findings in the context of what is known generally about the health of children in public care and makes suggestions for developing practice, including the establishment of a designated doctor for substitute child care.