'I spent the last two years arguing that surpluses are good, surpluses are what make you free,' David Nicholson told the NAPC conference.
'That gives me, as chief executive of the NHS, a responsibility to deliver that money back to you.'
'That view is not only held by me, it is absolutely held by Alan Johnson as well,' he added.
Mr Nicholson was speaking in response to comments made by King's Fund economist John Appleby the previous day.
Mr Appleby repeated his concerns, first outlined in a BMJ article last month, that the government could claw back nearly £3 billion of unspent NHS funding to help bail out the economy.
But Mr Nicholson said that the surpluses were key to paying for the redesign of services necessary over the next few years.
'Can you imagine if we had gone into the next period in the state we were in three or four years ago, half a billion pounds over budget?' he asked.
'The only issue is at what speed that money gets spent.'
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