Srinivas et al provide a comprehensive guide to the law, regulations and practice concerning the management of ‘restricted patients', who are the responsibility of both the clinical services treating them and the Home Office. In doing so, they make the assumption, with apparent approval, that there is a ‘partnership’ between clinicians and the Home Office. However, partnership assumes parties working towards a common goal on an equal footing. Neither assumption is correct here. Although forensic mental health services direct themselves explicitly towards enhancing public safety, they do so in conjunction with treatment aimed at the relief of dysphoria in the patient. The interest of the Home Office in the patient's mental health is solely in terms of its impact on the risk of harm to others. There is therefore no ‘partnership’. Rather, there is constructive tension between agencies working towards differently valued and balanced objectives. Certainly the relationship is not one of equal power.