Labour peers have failed in an attempt to add a new duty to promote integrated health and social care services, in the government's controversial bill to reform the NHS in England.
Lord Warner and Baroness Pitkeathley put forward an amendment, also signed by crossbencher Lord Patel, to that effect, during a third day of report stage on the Health and Social Care Bill.
But peers rejected the proposal by 227 votes to 206, majority 21, on 27 February 2012.
Moving the amendment, Lord Warner - a former Labour health minister - said it would be a "missed opportunity" if the bill was not changed in order to promote integrated care and to require health bodies to report annually on how this was being delivered.
Lady Pitkeathley, vice president of the Carers National Association, argued that the benefits of delivering more effective and efficient care were obvious to patients and the wider community.
Speaking for the opposition, shadow health minister Baroness Thornton welcomed the "modest but very important" amendment, arguing that it would "strengthen" the legislation.
However, the health minister, Earl Howe, feared the move would be "counter-productive" because the concept of integrated care was "difficult to define" and risked being "too narrow" in some cases.
He insisted the government was "fully committed" to integration, which he said lay at "the heart" of the bill.
Earl Howe added: "This bill will for the first time create duties for NHS bodies to promote and encourage the commissioning of integrated services.
"It is is a difficult concept to define and I think while Lord Warner is to be congratulated for the attempt he has made in his amendment, I fear it won't take us very far."
The minister urged Lord Warner to withdraw the amendment but the Labour peer forced a vote on the matter, maintaining that a definition should be included in the bill.
Earlier on in the debate, another Labour amendment - seeking to introduce tighter controls on clinical commissioning groups to prevent potential conflicts of interest - was defeated by 259 votes to 186, majority 73.