The head of the Royal College of Nursing last night rubbished a boast by Health Secretary Patricia Hewitt that the NHS was enjoying its "best year ever".

Dr Beverly Malone, General Secretary of the RCN, said if this was the best year ever she would "dread to think" what a worse one would be like.

She claimed that nurses losing their jobs and patients having to make long journeys for treatment would not recognise the picture painted by Ms Hewitt.

There was widespread surprise at the remarks by the Health Secretary, with the NHS facing estimated debts of more than #600 million and thousands of job losses.

Conservative leader David Cameron said: "I heard Patricia Hewitt saying this and I wondered what planet she's living on." More than 7,000 NHS job losses have already been announced and the RCN said the final number could be 13,000.

Dr Malone said: "Real patients and real nurses do not experience this as the best year ever.

"Patient services are being cut, nurses and other NHS staff are losing their jobs. If this is the best year ever, I dread to think what a year worse than this could look like.

"If I was a patient who had to travel an extra 40 miles to get treatment, or has had their treatment postponed because of NHS deficits, I would not think it was the best year ever.

"If a was a nurse losing my job or a newly qualified nurse unable to find a job, I would not be thinking that this is the best year ever.

"If I was one of the senior nurses who said in a RCN survey that they are under too much pressure, with too few staff and unable to give the care to patients they really want to, I would not say this is the best year ever."

Ms Hewitt said: "Despite the headlines, actually the NHS has just had its best year ever.

"We have just come through one of the coldest winters for decades and we haven't had any of the winter bed crises. We got the waiting times down to the lowest level ever."

But a Unison spokeswoman said: "Try telling that to some of the nurses, health care assistants, and other health workers who now fear for their jobs because of the deficits across trusts. Try telling that to patients and the public who are fighting to keep open some of their community hospitals and hospital wards."

Mr Cameron said: "I just can't think what she is talking about. There is a crisis in the NHS. We shouldn't over-use that word, but there is a crisis - these levels of redundancies, these levels of closures.

"It's a crisis that was pretty much manufactured in Downing Street because the Government has mismanaged the health service."

A spokesman for health think-tank, the King's Fund, said: "Whilst it is true to say the NHS hasn't been plagued by typical winter problems such as a flu outbreak, it is ending the year on a financial low - with almost a quarter of trusts and health authorities predicting a deficit for the financial year end."

Ms Hewitt's boast came as it was revealed that miscalculations in salary packages for NHS staff have led to a pay bill more than #600 million higher than expected.

The Department of Health acknowledged it had underestimated the financial impact of the so-called Agenda for Change package for nurses' pay by #220 million, while the cost of new consultants' contracts was #90 million more than expected.

The figures come on top of the #300 million overspend on GPs' pay admitted earlier this month by Ms Hewitt, who said the department had not expected GPs to be able to rack up 20-25 per cent pay hikes under a new payment-by-results points system.