BORIS Johnson is expected to face a battle with peers over his health and social care reforms after they cleared the House of Commons following another sizeable rebellion.

The Health and Care Bill was given a third reading by 294 votes to 244, majority 50, thereby paving its way to progress to the Lords.

But a total of 18 Conservative MPs rebelled at report stage in support of an amendment which sought to introduce better workforce planning for care in England.

The division list showed Jeremy Hunt, the architect of the amendment, was supported in the division lobbies by 17 colleagues – including former cabinet ministers Greg Clark, Esther McVey and Chris Grayling.

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But his proposal was ultimately rejected by 280 votes to 219, majority 61.

It followed a crunch vote on Monday evening which saw the Prime Minister’s majority slashed to 26 as 19 Tory MPs rebelled to vote against a change to social care reforms amid anger over how it will hit poorer pensioners.

Johnson narrowly succeeded in getting MPs to back his new policy to cap care costs in England although ministers were unable to say whether the change to the £86,000 cap on care costs would fulfil an election pledge to guarantee no-one would have to sell their home to pay for care.

Critics of the policy have warned the move to count only individual payments towards the cap, and not local authority contributions, would cost poorer recipients more in assets than the wealthy.

Both proposals are expected to be considered further in the Lords.

On Tuesday, Hunt warned of “short-termism” in workforce planning and called for independent assessments to be published every two years setting out staffing needs.

He also argued that training more doctors for the NHS would help reduce the £6 billion annual bill for locums and improve patient care.

After the vote, Hunt vowed to press on with his campaign when the Bill is considered in the House of Lords.

The chairman of the Health Select Committee wrote on Twitter: “The Bill can still be amended in the Lords so we’ve lost the battle but not the war.”

Conservative former cabinet minister Andrew Mitchell, who voted in favour of Hunt’s amendment, argued “pinching doctors from the developing world to make up for the shortfall” was “grossly irresponsible”.

The MP for Sutton Coldfield said: “Burnout in the NHS is an incredibly serious issue, the need for us to project how many we’re going to need in all the different disciplines in the health service has never been greater and the workforce requirements have never been more uncertain and the cost of the uncertainty… is paid in locums, with all the difficulties and downsides that have been mentioned.”

The Government declined to support the amendment, with health minister Edward Argar insisting it was taking the issue seriously.

It did, however, support an amendment from Conservative MP John Baron (Basildon) to require objectives to be set for the NHS on cancer treatment which are defined by outcomes – such as one-year or five-year survival rates.

MPs also voted 304 to 240, majority 64, to reject an amendment designed to give legal protection to the title of nurse – amid concerns some people have used it to spread misinformation.

The Bill as a whole seeks to reform the NHS to make it less bureaucratic and more accountable.

As part of this effort, new regional authorities called Integrated Care Systems are being set up across England.

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But concerns have been raised that the Bill represents a power grab by ministers and a “corporate takeover” of the NHS.

Speaking at third reading, Health Secretary Sajid Javid said on the social care cap plans: “This Bill now reflects our commitment to end the crisis in social care and the lottery of how we all pay for it. It’s not right and it’s not fair that the heaviest burdens often fall on those that are least able to bear it.

“We are introducing a cap on the care cost so that no-one will have to pay more than £86,000 in their lifetime, a cap that will be there for everyone, regardless of any condition that they have, how old they are, how much they earn and where they live.”

But shadow health secretary Jon Ashworth said: “This is an extensive reorganisation of the National Health Service at a time when we are still in a pandemic and at a time when NHS staff are exhausted and facing burnout and should be prioritising the monumental waiting lists, the huge referrals for mental health treatment, the crisis in A&E, the huge pressures on ambulance services, the huge pressures facing general practice. We believe this is a distraction at this time.”