It is impossible to pick up a government report these days without the terms 'partnership', 'teamwork' and 'joined-up working' leaping off almost every page. For all the new-found enthusiasm for them, none of these notions is new, as numerous articles published in HSJ alone testify. Indeed, there is much about the language of working together that induces a big yawn. After all, we've been here many times before over the past quarter-century, notwithstanding shifts in language.

Yet, depressingly, the debate rarely gets beyond first essentials.

This is so despite the existence of a robust evidence base identifying the criteria governing effective partnerships. Is the problem simply a deep-seated inability to act on the evidence? Is it a development deficit insofar as those entrusted with making partnerships work lack the qualities needed to secure sustainable joined-up working?

Or is there a deeper reason?

The problem probably has its roots in all of these factors, but maybe more attention should be accorded the last. The thought is triggered by Richard Sennett's penetrating essay The Corrosion of Character, which amounts to a critique of modern capitalism and market relations.

1In a discourse on 'teamwork', Sennett asserts that it 'takes us into that domain of demeaning superficiality which besets the modern workplace'. He observes that groups tend to hold together through keeping to the surface of things - 'shared superficiality keeps people together by avoiding difficult, divisive, personal questions'.

What no longer exists is the notion of 'authority'. The result is power without it. The fiction is maintained that everyone is a member of the team or partnership and on the same side. It is as if organisational politics were a foreign concept.

The 'leader', a term Sennett claims is the 'most cunning word in the modern management lexicon', is someone who is on your side rather than your boss' exercising power over you.

You do not have to agree with the entirety of Sennett's thesis to share his discomfort about the nature, and beguiling appeal, of teamwork and partnerships.

Might the endless exhortations to work together simply be (or become) another form of oppression and suppression in which authority is concealed from view by soothing blandishments about everyone being united in a common purpose, whether it be the ending of health inequalities or prevention of 'bed blocking' through improved co-operation across the health-social care divide?

Deep, lasting partnerships can only be established where there are stable long-term relationships and real trust can emerge. But all the pressures associated with short-term deadlines, and the demand for instant results, militate against such partnerships being given a fair wind. Perhaps we should be more honest about the likelihood of such partnerships failing other than in exceptional circumstances.

Need partnership working be so demeaning or might it be possible to make a virtue of the short-termism and opportunism that are more general characteristics of our relationships, whether public or private? We should avoid the search for perfection driving out what might still be an improvement on existing practice.

We place intolerable and unattainable expectations on working together. But why should we expect more from partnerships than we expect from other facets of our working or private lives?

In contrast to perfect partnerships, we might stand a better chance of success if we settled for 'co-operative partnerships'. These have been defined as partnerships in which there is a recognition of enlightened self-interest and where partners can pursue their own goals most effectively by cooperating with others.

Such partnerships have been called 'low-maintenance partnerships' because minimal time and effort is expended on them.

Of course, the risk with cooperative partnerships is that they remain at the level of superficiality and do not tackle the hard issues. At best, however, they are a stage along the way to 'co-ordinating partnerships' based on mutual trust and a deeper level of understanding. At worst, working together may go no deeper, though it may still yield useful benefits.

It is naive and a huge waste of resources and effort to believe that the hard issues can be tackled simply through legislating for working together or by establishing new structures, such as care trusts.

We need to be clear about what working together is intended to achieve by way of added value and improved outcomes, and be clear about who is accountable for results. It is all too easy to fudge this issue in a partnership or team and talk loosely about 'facilitators' and 'process managers' who are not truly engaged with achieving better outcomes for people. As an end in itself, working together is a rather nebulous form of self indulgence. It has to have grip and be judged according to the results it achieves.

A further twist is evident in the fashionable promotion of public-private partnerships across the public sector. How does the traditional public service ethos square with the new capitalism and its indifference to those it employs and readily disposes of as required? Such an ethos surely runs counter to the essence of what true partnership working is intended to mean, which is about genuine caring for one another.

Better, then, to drop the pretence that working together is anything other than a more sophisticated form of exploitation. Or is that being too cynical?