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Children in the ‘care’ system are known to have poor health. Although health services can respond to and deal with health problems, it is parents, foster parents and social workers who recognize problems, seek advice and keep follow-up appointments. Many health needs remain unmet in such children. This short paper from a deprived area in north-east England shows that once a decision is made to proceed to adoption, the stable and consistent care that can then be provided meets the increased health needs that such children have.