The government has seen off a rebel Liberal Democrat bid to halt the controversial health reforms.
The move, which had the support of the Labour front bench, was defeated by 314 votes to 260, majority 54.
The rebel leader, Andrew George, called for the Health and Social Care Bill to be dropped and urged ministers to hold a summit with medical groups and patients’ organisations to thrash out a new set of reforms based on the coalition agreement.
Mr George (St Ives) tabled his proposals as an amendment to a Labour motion that also called for the troubled legislation, which cleared another hurdle in the Lords tonight, to be scrapped.
He said the bill had “many failings” and the amendments that the government had been forced into accepting had made it “less bad but not sufficiently good enough” to be pushed through Parliament.
Andrew Lansley said the reforms to the NHS in England were “the right idea”.
Labour’s motion to scrap the bill was also defeated, by 258 votes to 314, majority 56.
The Commons debate came as the vill entered its final parliamentary stages amid mounting anger at the scale of the reforms and following hundreds of amendments in the House of Lords.
The bill completed its report stage in the Upper House but could still face a further test at third reading.
Supporters say the shake up will give GPs more control over how NHS money is spent, but critics - including a host of bodies representing medical staff - fear it will lead to too much focus on competition and greater involvement from private companies.
Opening the Opposition-led debate, shadow health secretary Andy Burnham said 177,000 people had signed an e-petition on a government website demanding ministers drop the bill.
“Time is running out for the National Health Service,” he told MPs.
“It is now sheer gut loyalty, political pride and the need to save face that are the only forces driving a deeply defective Bill towards the statute book.”
He said: “The bill makes it possible for clinical commissioning groups to take responsibilities to doctors and nurses to design better services - and because of the legislation it will happen and it will not be suppressed by a top down bureaucracy.”