The National Health Service in England is heading for a surplus of £1.8 billion this year, provoking anger among patient bodies over cutbacks to the funding of care.

Details announced yesterday by the Department of Health reveal that some health authorities are expected to generate more than £200 million, 25 per cent of their income.

The department played down the £1.8 billion figure last night as a mere 2.3 per cent of turnover, but patient representatives said that it was astonishing that the NHS could be underspending by more than a billion pounds while patients were still being denied vital treatments.

Michael Summers, of the Patients’ Association, said: “When wards are closing and hospitals are cutting back on cleaning and nursing staff up and down the country, it is quite astonishing that they are generating such a huge surplus.”

Last month a former Second World War airman, Jack Tagg, was told by his local primary care trust in Torbay, Devon, that he could not be given drug treatment for age-related macular degeneration because it was too expensive. The trust, which later relented but only on a technicality, is heading for a £7.8 million surplus, 3.5 per cent of turnover, this year.

The figures were released on the same day that the Government said that it would not match moves by the Welsh Assembly to abolish parking charges in NHS car parks. Doctors and patients’ groups say that hospital car parking charges are a “tax on the sick” if they are used to subsidise services already funded by the taxpayer. From 2011 patients, staff and visitors will be able to park free at almost every NHS hospital in Wales.

A Department of Health spokesman said: “We have no plans of forcing hospitals in England to subsidise their car parks with resources that could be used to improve and speed up patient care. It would also be contrary to the Government’s climate change objectives.”

The biggest surpluses have been made by the strategic health authorities: North East SHA, for example, expects to generate a surplus of more than £100 million on a £346 million turnover; North West SHA a £230 million surplus on a turnover of £877 million and Yorkshire and the Humber SHA £267 million on a £784 million turnover. The total surplus is equivalent to almost 1p off income tax.

The Department of Health said yesterday that all the surpluses would remain within the NHS. This has been possible since 1999, when Gordon Brown, then Chancellor of the Exchequer, relaxed the rules on carrying forward surpluses from one year to the next.

Last month the National Audit Office gave warning that some departments were losing confidence in the Treasury continuing to allow them to do this as public spending slows. By last April departments were sitting on £10 billion of unspent capital spending and £12 billion in unspent revenue.

The NHS has been told that it is expected to make at least as large a surplus in 2008-09 as it looks like making in 2007-08. Two years ago the NHS returned a deficit of £547 million, which was turned into a £515 million surplus in 2006-07. The steps taken to turn the service round have proved so effective that the surplus has risen to unprecedented levels in 2007-08.

David Nicholson, chief executive of the NHS, said: “Today’s report not only shows that the NHS now has a strong and sustainable financial position, but also, importantly, it shows that we remain on course to deliver against our key pledges.”

Karen Jennings, head of health for Unison, the public service union, said: “The £1.8 billion surplus shows the NHS is now in a much stronger financial position. Patients have the right to expect that this money is spent wisely and ploughed back into patient care.

“It must be remembered that the stronger financial position has been achieved on the backs of NHS staff. They have contributed through greater efficiency but there have also been job losses and below-inflation pay awards. With finance available it is time to give staff a decent pay settlement instead of holding them to a 2 per cent pay limit.”

Stephen O’Brien, the Conservative health spokesman, said: “The Government cannot have it both ways. They are boasting about a £1.8 billion surplus in the NHS but then claim that hospitals cannot improve patient care without revenue from car parking fees. This does not add up.”

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