The outcomes for children in public care are generally considered to be poor. This has contributed to a focus on reducing the number of children in care: a goal that is made explicit in the provisions of the current Children and Young Persons Bill. Yet while children in care do less well than most children on a range of measures, such comparisons do not disentangle the extent to which these difficulties pre-dated care and the specific impact of care on child welfare. This article explores the specific impact of care through a review of British research since 1991 that provides data on changes in child welfare over time for children in care. Only 12 studies were identified, indicating a lack of research in this important area. The studies consistently found that children entering care tended to have serious problems but that in general their welfare improved over time. This finding is consistent with the international literature. It has important policy implications. Most significantly it suggests that attempts to reduce the use of public care are misguided, and may place more children at risk of serious harm. Instead, it is argued that England and Wales should move toward a Scandinavian system of public care, in which care is seen as a form of family support and is provided for more rather than fewer children and families.