<b>Background</b> GPs contribute to preventive child health care in various ways, including provision of child health
surveillance (CHS) reviews, opportunistic preventive care, and more intensive support to vulnerable children. The
number of CHS reviews offered in Scotland was reduced from 2005. This study aimed to quantify GPs’ provision of
different types of preventive care to pre-school children before and after the changes to the CHS system.<p></p>
<b>Methods</b> GP consultation rates with children aged 0–4 years were examined for the 2½ years before and after the
changes to the CHS system using routinely available data from 30 practices in Scotland. Consultations for CHS
reviews; other aspects of preventive care; and all reasons were considered.<p></p>
<b>Results:</b> Prior to the changes to the CHS system, GPs often contributed to CHS reviews at 6–8 weeks and 8–9 and
39–42 months. Following the changes, GP provision of the 6–8 week review continued but other reviews
essentially ceased. Few additional consultations with pre-school children are recorded as involving other aspects of
preventive care, and the changes to CHS have had no impact on this. In the 2½ years before and after the changes,
consultations recorded as involving any form of preventive care accounted for 11% and 7.5% respectively of all
consultations with children aged 0–4 years, with the decline due to reductions in CHS reviews.<p></p>
<b>Conclusions:</b> Effective preventive care through the early years can help children secure good health and
developmental outcomes. GPs are well placed to contribute to the provision of such care. Consultations focused on
preventive care form a small minority of GPs’ contacts with pre-school children, however, particularly since the
reduction in the number of CHS reviews