There are some 40000 children ‘in care’ in England and Wales, i.e. being ‘looked after’ by local authorities and living in foster and residential homes. These children come from highly disadvantaged social backgrounds and are likely to experience more serious health problems than the wider population. Despite this, there is evidence to suggest that their health needs are frequently neglected. This is reflected in the dearth of research information. Health professionals play a key role in combating child abuse and are particularly concerned about future mental health, self-injury and high levels of pregnancy in this group of children. Health promotion is therefore vital, but is complicated by the fact that this group of children often do not attend school. The Department of Health has introduced a major initiative which has a strong health dimension to help promote better care planning and monitoring for children who have been separated from their parents.