Health secretary Frank Dobson last week promised to revive Britain's ailing school health service as part of a drive to improve child health which would also see local authorities taking responsibility for children in care up to the age of 18.

'It is difficult to think of anything more worthwhile than making life healthier for the children of this country,' he said.

And he was warmly applauded when he promised to beef up the health service in schools. 'The school health service is so run down and I want to see it restored,' he told delegates at a British Medical Association conference.

'We have to look at how we get good quality preventive healthcare available to children, and a well-run, well-resourced school health service is part of that,' he said.

Mr Dobson said society had failed children in care. 'We really have let them down, the last thing some of them have got is care.'

It was, he admitted, only when he became health secretary that he discovered local authorities 'could turn 16-year-olds out of care and on to the streets'.

'I have been absolutely determined to change that,' he said.

Mr Dobson resorted to his favourite comparators, Hackney, in east London, and Surrey, to hit home his points about variations in death and sickness rates. But he pointed out there were differences in funding, too.

While East London and the City health authority gets 4.7 per cent less than it is entitled to, Surrey gets 2 per cent more.

Mr Dobson said the formula was 'seriously wrong' and was under review to try to ensure that funds 'get to more of the places that need them'.

He rehearsed a number of initiatives which he said would contribute to improving child health, including health action zones and health improvement programmes, the minimum wage, funding for house improvements, attempts to reduce teenage pregnancies and steps to reduce road accidents.

But he concluded: 'The situation is not at all satisfactory. We have an enormously long way to go... It will be a very long-term programme.'

Earlier, former chief medical officer Sir Donald Acheson called for free fruit in schools - even on a trial basis - and a reduction in sweet vending machines as a step towards improving child health.

Referring to the report of his independent inquiry into inequalities in health, published last November, Sir Donald said it had been welcomed by prime minister Tony Blair.

'But,' he cautioned, 'it is one thing to welcome it and another to do something about it.'

He reminded the conference of two of the report's findings. The first was that a third of children live in families with less than 50 per cent of the average income, after housing costs; for adults the figure is a quarter.

'Poverty is substantially commoner in children than in adults and it is very common in this country,' he said.

The second finding was 'even more horrifying'. The number of children in poverty in 1979 was one in 10. 'So this is something that has got worse during the working lives of most of the people in this room.'

He said studies showed that money for food was often used as a reserve to iron out financial fluctuations and the amount spent on groceries fell in the second week of the benefit cycle.

Asked how constrained the review committee had been by the government, Sir Donald said the Treasury had asked it to consider affordability and cost-effectiveness, but members had agreed that was a matter for the government and not for them.

Responding to a question, Sir Donald made a case for contraceptive help for schoolchildren. 'We have to be less prissy about the availability of contraception to schoolchildren,' he said. 'There must be much more openness about the provision of contraceptive help for children in school.'

Earlier, Dr James Appleyard, chair of the BMA's child health working party, said the needs of children were not given enough priority. Although the government was moving in the right direction, it had not yet made children's health needs a headline target, he said.

The public gave children's health needs a very high priority, professionals set them a bit lower and health service managers relegated them lower still, said Dr Appleyard. He called on policy-makers to be made more accountable for their actions.

He said a study of infant mortality in east Kent, from 1988 to 1996, shows that the 20 wards with the highest infant death rates were generally further away from paediatric services, and argued that high mortality rates related to lack of access to services.

Dr Appleyard said money used for children's health would bring rewards later, perhaps offering£8 worth of health gain for every£1 spent.