Current emphasis on intriguing gains in our understanding of child psychopathology, though of major importance, should not weaken our attention as mental health professionals to “old” issues that tend to be ignored both because they render us helpless despite our increasing knowledge and because they seem so hard to remedy. I refer to those children who are subjected to severe disadvantaged conditions, both materially and psychologically, with parents who provide grossly inadequate or severely abusive care to them. These children may be considered for placement in foster care. Although there have been arguments against long-term foster care and in favour of short-term care, long-term foster care remains a persistent and important form of substitute care. The question must then arise as to whether permanent foster care can provide adequate alternatives. Practitioners are sometimes confronted with the detrimental effects of “oscillation” of children in and out of care, and reluctance as to the decision to place the child into permanent foster family care. Minty, in this issue's Annotation, provides an overview of the outcomes of long-term foster family care. Contrary to much current prejudice, Minty shows that there is ample evidence that long-term foster family care can provide a satisfactory upbringing for most children who lack adequate care in their birth families—provided that foster care begins early in life and continues at least until the late teens. Large-scale longitudinal studies have found that where psychosocial development is disturbed and educational progress deficient, these inadequacies are largely attributable to the social factors impinging on children before admission to, and discharge from, family foster care. Nevertheless, there is room for much improvement in the educational attainments of foster children, and there needs to be better training in the safe caring of children who have previously been seriously abused. Also, it is clear from Minty's overview that more methodologically sound research is needed to unravel the mechanisms that hamper or facilitate the healthy development of these children.