Health campaigners have warned that the NHS still faces job cuts after fears that up to 700 posts are to be lost at a foundation trust.
Thousands of staff at County Durham and Darlington NHS Foundation Trust have received letters offering them voluntary severance payments, it was revealed.
Union officials said the move could herald the loss of up to 700 posts over the next three years.
Geoff Martin, of campaign group Health Emergency, said: "Anyone who thought that the projected NHS financial surplus would draw a line under the cuts to jobs and services should take a look at what's happening in Durham and Darlington today.
"The cuts are still on the agenda in many parts of the country as cash surpluses are stockpiled to bail out Gordon Brown and his government when a new wave of financial pressures hit home later this year."
Union officials said the severance package on offer undercut a national redundancy package and members will be urged not to take it up.
The trust has said the scheme was entirely optional and was not the same as a redundancy scheme.
