SummaryThe debate about provision of health surveillance programmes for preschool children is described. Improvement in the health of the child population has caused a need for its continuance in its present form to be questioned. The aspects of child health and development that still cause concern and the current approaches to them are reviewed. The problem of disadvantaged children and their health needs are discussed. Changes in social policy are required as well as continued initiatives in the provision of preventive health care for vulnerable families.