The foundation trust with the biggest surplus is about to start spending it.
The board at University College London Hospitals foundation trust is today expected to give the final go-ahead to a£110m cancer centre that will be funded almost wholly from its surpluses.The centre's design is based on research into why cancer patients in the US survive longer than those in the UK.
Chief executive Sir Robert Naylor said: "We plan to bring the best of US-style cancer care to London by building a centre where each floor is designed around the needs of patients with different cancers. This will be a first for the UK."
The hospital is due to open in 2012. The trust plans to invest£61m in 2008-09, and a further£62m from 2009-11 on the centre and other building.
Much of the investment will stem directly from its accumulated surplus, which was£120m at the end of last financial year. The bulk of that came from the£170m sale in 2007 of the redundant Middlesex Hospital site in central London.
Sir Robert told HSJ: "With the sale of the Middlesex we hit the top of the property market cycle." Indications of building prices dropping "makes a double positive for us because we can build the new cancer centre far more cheaply".
Middlesex Hospital was bought by a joint venture company formed by UK developers Candy and Candy and the failed Icelandic bank Kaupthing. A spokesperson for Candy and Candy said it had now disposed of its interest in the development.