One third of NHS hospitals raised parking charges last year, netting more than £254m, and with private firms bagging much of the profits.
An investigation by the Press Association found that 47 NHS hospital trusts out of 144 (33%) increased their parking charges last year, despite increasing pressure to scrap, or lower, the controversial fees.
A record high £254,373,068 in charges and fines from patients, staff and visitors was recorded in 2018-19 – a 10% rise on the previous year.
And some 65 trusts said their car parks were managed by private companies, and in 23 of those cases the operator took all the profits made from parking fines.
North Tees and Hartlepool Hospitals NHS Foundation Trust charges £4 per hour for parking, compared to Pennine Acute Hospitals NHS Trust which charges just £1 an hour.
The biggest earner was the Manchester University NHS Foundation Trust, which collected £6.3m.
At the same time, a survey of 7,883 car park users found many were unhappy with the service at their local hospital.
86% said parking at hospital stresses them out and the charges have been described as 'a rip-off', 'extortionate' and 'astronomical'.
All charges by trusts for parking cover the day-to-day running of car parking at the hospital, with any surplus reinvested back into wider services for patients or improving these facilities
And one in three people (32%) said they struggled to find a space, and 10% said they were confused by car parking rules.
Commenting on the findings, a spokesman for the Patients Association, said: “Charges for car parking at hospitals are a charge on people who are unwell, levied on them because they are unwell.
“We believe that patients should not be effectively charged for being ill.”
Hospital parking in Scotland, Wales and Northern Ireland is already largely free of charge and pressure is mounting on the English government to follow suit.
But the charges were defended by NHS Providers, the body which represents healthcare managers.
Charges for car parking at hospitals are a charge on people who are unwell, levied on them because they are unwell
Its spokeswoman, Saffron Cordery, told the BBC: “Car parks are expensive to run for the trusts that own them.
"Parking facilities must be maintained, lit well, and secure.
"All charges by trusts for parking cover the day-to-day running of car parking at the hospital, with any surplus reinvested back into wider services for patients or improving these facilities."
Abolishing charges would mean trusts would have to find funding from elsewhere, which could impact on patient care, she added.