A government move to give legal standing to the new NHS constitution has been defeated in the House of Lords by a majority of four.
The shadow minister for health, Earl Howe, moved an amendment of the Health Bill to allow the health secretary to make regulations relating to the constitution.
Earl Howe raised questions as to whether Parliament should have a say in the content of the NHS constitution.
He said that although the NHS constitution was signed off by the prime minister, its implementation had been detached from parliamentary process.
"The constitution is intended to underpin the values and modus operandi of the entire NHS for the next 10 years at least and as such has been promoted by the government as being a text of fundamental significance for both staff and patients," he said.
He went on to tell peers that without approval from Parliament the NHS constitution document has no legal standing.
Earl Howe said his amendment would allow regulations relating to the principles behind the constitution to be set out by the secretary of state.
"That statutory instrument would be the direct link between Parliament and the constitution and would legitimise the content of the document," he added.