The Government's reform programme for the NHS cleared a crucial hurdle today as it received a second reading in the House of Lords.
Peers rejected by a margin of 330-262 an attempt by former SDP leader Lord Owen to delay the Health and Social Care Bill by referring it to a special committee.
They earlier voted down a bid to kill off the legislation altogether by refusing it a second reading, defeating an amendment from Labour's Lord Rea by 354 votes to 220.
Lord Owen denied his amendment was designed to block the Bill by preventing it clearing Parliament by the end of the session next spring.
He insisted that a special committee was the only way to ensure the complexity of the controversial changes - which will see responsibility for the vast majority of health spending handed over to GPs and clinicians - was properly examined.
But health minister Lord Howe yesterday wrote to peers warning that any delay "could well prove fatal" to the legislation, adding: "This is not a risk that I believe this House should take."
Today's votes clear the way for the Bill to continue through the committee and report stages of the Lords before being passed into law.
A Department of Health spokesman said: "Today's vote is an important step towards giving the NHS the clarity and certainty it needs and delivering a world-class health service for patients.
"We look forward to full scrutiny in the main Lords committee, drawing on peers' wide expertise to ensure that our modernisation plans are as effective as possible."
But, despite today's victories, Health Secretary Andrew Lansley may still face a protracted struggle getting his plans on to the statute book by the end of the session in April.
One Labour peer said Lords authorities should "dust off the camp-beds" in anticipation of late-night sittings during the committee stage of the Bill, which will take place on the floor of the House.
And shadow health secretary Andy Burnham said Labour would fight for "substantial and drastic" changes to the legislation if Mr Lansley was not willing to drop it now.
"The best thing for the NHS right now would be to drop the Bill so it can focus on the financial challenge and get through this dangerous period," Mr Burnham told BBC News.
"Instead, the Government is locking it into this period of limbo, this protracted debate.
"Let's be clear, this fight is going on. It will be debated now over a number of weeks - even months - in the House of Lords, line by line, clause by clause. And Labour will be wanting changes to this Bill, substantial and drastic changes to it.
"This is far from over. In fact, the Government are digging in for the long haul and that is not going to help our National Health Service."
During two days of passionate debate in the Lords, the reform plans came under sustained attack from many of the 100 peers who queued up to speak.
Fertility doctor and television presenter Lord Winston denounced the Bill as "unnecessary and, I'm afraid to say, irresponsible".
Labour's deputy leader in the Lords, Lord Hunt of Kings Heath, said: "The scale of concern, the scale of mistrust amongst the NHS and amongst the public is greater than I have ever known it before."
And Baroness Finlay of Llandaff, a former president of the Royal Society of Medicine, said: "The vast majority of the changes can happen without this Bill and indeed the most important ones are already happening."
But Conservative former health secretary Lord Fowler warned it would be "unacceptable" for peers to block the legislation, warning: "Unless we are careful, we will leave the health service in uncertainty about the future. We will leave them in suspended animation. I don't believe that anyone who is committed to the National Health Service wants to see that."
And Lord Howe attempted to calm fears that the extension of market mechanisms which the Bill envisages would undermine the principles of public health-care.
"The Bill does not do anything that may or could lead to the privatisation of the NHS," said the minister.
But he said reform was needed, adding: "Money will no longer grow on trees in the NHS, we have to think outside of the box."
During the two-day debate, an instant petition run online by the 38 Degrees lobby group gathered more than 150,000 signatures urging peers to block the Bill.
Public sector union Unison said peers had "let down" opponents of the NHS reforms and vowed to keep up pressure for change to the legislation.
Unison's head of health, Christina McAnea, said: "We are bitterly disappointed that too many Lords failed to listen to the groundswell of opposition from the public, health professionals, charities, staff and unions to the dangers of the Health and Social Care Bill.
"Today the Lords failed to save the NHS, but there is still a long way to go before this Bill goes through. Unison will continue to keep up the pressure to make changes to this destructive Bill."