The concept of paediatric psychology is relatively recent, having evolved in 1967 in the USA, largely within general hospitals, where paediatricians were faced with numerous childhood problems requiring comprehensive medical/psychological treatment approaches. The rationale was that psychological services should be focused where the majority of problems first present, i.e. in a medical setting rather than a psychiatric hospital. Against this background, the prevalence of childhood psychopathology, as encountered at a Pietermaritzburg general hospital, is discussed. However, the increasing demand for psychological consultations raises the issue of management of these children at other general hospitals, since very few employ psychologists.