Doctors, nurses, lecturers, teachers and other public employees who resist the Government's plans for reform are "knaves" motivated by "plain self-interest", according to an expert taken on last week as a policy adviser by Tony Blair.
The comment by Julian le Grand, one of Britain's most eminent academic commentators on public policy, will take on new significance now that he has been given a six-month placement with the Downing Street policy directorate. He has disputed the claim made by union leaders and the Labour left that the Government's public sector reforms pose a threat to the "spirit of caring".
For many who use the NHS and other services, that sort of public spirit is likely to take the form of "arrogant, insensitive, uncaring, overweening" behaviour, even from professionals who have no selfish motives, because "the altruist may feel that he or she is superior to the beneficiary."
In an extract from his latest book, published in last week's New Statesman magazine, Professor le Grand, professor of social policy at the London School of Economics, said that "public service reform has few friends on the left. A potent source of hostility is plain self-interest. Exposure to outside pressure, whether from targets, league tables or user choice, can be uncomfortable and threatening, and people would prefer not to be subjected to it.
"In the terminology of the 18th-century philosophers, the professionals and other public sector workers opposing reforms are 'knaves' - self-interestedly protecting jobs and income."
But Professor le Grand acknowledges there is a "more sophisticated view", which sees employees who oppose reforms as "knights" fighting to protect public services, rather than "knaves". But, he said, even if their motives are idealistic, they are not necessarily showing respect for the people who use the services.
"The problem with state monopolistic public services is the degree of power they give to providers - arrogant doctors, insensitive teachers, uncaring social workers, overweening bureaucrats. There seems little respect. Instead, there is deference and resignation on one side, and indifference and condescension on the other," he wrote.
The comments have angered workers' leaders. Kevin Curran, general secretary of the GMB general union, said: "By resorting to medieval name-calling he has missed the actual problems facing public services in this century. The answers will not be found in the abstractions of dead philosophers. Real improvements to our services only happen when front-line workers are consulted."