MPs have backed a new four-week coronavirus lockdown for England, after Boris Johnson warned of an “existential threat” to the NHS without action to curb the spread of the disease.

From Thursday, pubs, restaurants and non-essential shops will again be forced to close their doors after the Commons voted by 516 to 38 – a Government majority of 478 – for the new restrictions.

However, in a bigger than expected Commons rebellion, 32 Tory MPs defied the whips to vote against the measures, with two more acting as tellers for the noes.

The new restrictions were then cleared through Parliament after they were approved by the House of Lords.

Peers voted against a bid to block the second national lockdown in England.

Tory former minister Lord Robathan’s so-called fatal motion to the regulations was defeated by 30 votes to 376, majority 346.

The move came as the NHS in England was set to move into its highest alert level – level 4 – from midnight amid a continuing rise in coronavirus patients needing hospital care.

NHS England chief executive Sir Simon Stevens said the service already had “22 hospitals’ worth” of Covid-19 patients and now faced a “serious situation ahead”.

Professor Stephen Powis, NHS England’s national medical director, said the number of people in hospital was rising across the country, including in the south of England.

With Labour supporting the new lockdown restrictions – which were also expected to be approved by the House of Lords later on Wednesday – the Government’s majority was never in doubt.

However Mr Johnson faced an angry backlash from some Tory MPs – led by former prime minister Theresa May – alarmed at the economic impact of the controls as well as the curtailment of civil liberties.

In the Commons, the Prime Minister sought to reassure MPs that the measures – which are due to expire on December 2 – should enable shops and businesses to reopen in time for the run-up to Christmas.

He acknowledged however that it would depend on getting the R number – the reproduction rate of the virus – back down below 1.

Opening the debate, Mr Johnson said that without action now, the chances of the NHS being in “extraordinary trouble” by December were “very, very high”.

“Let me be clear that this existential threat to our NHS comes not from focusing too much on coronavirus, as is sometimes asserted, but from not focusing enough,” he said.

“We simply cannot reach the point where our National Health Service is no longer there for everyone.”

Labour leader Sir Keir Starmer said that while the restrictions were not “desirable or perfect”, they were necessary as the Government had “lost control of the virus”.

However, Mr Johnson faced a barrage of criticism from some Tories who questioned the statistics used to justify the lockdown, including one forecast suggesting there could be 4,000 deaths a day.

Mrs May said pointedly that Parliament would make better decisions if it was “fully and properly informed” about the facts.

“For many people it looks as if the figures are chosen to support the policy rather than the policy being based on the figures,” she said.

Sir Graham Brady, influential chairman of the Tory backbench 1922 Committee, questioned whether the Government had any right to take some of the measures it wanted.

“The thing that troubles me most is that the Government is reaching too far in to the private and family lives of our constituents. I think there is an, unintended perhaps, arrogance in assuming the Government has the right to do so,” he said.

Former Tory leader Sir Iain Duncan Smith complained the Government had been “bounced” into the lockdown after details were leaked over the weekend.

“Whoever did it should be sacked, strung up to dry, come here to apologise, grovelled out the door on hands and knees and beaten on the way out frankly. This is appalling what they have done,” he said.

There is no health service in the world that by itself can cope with coronavirus on the rampage

Earlier, Sir Simon said NHS hospitals in England currently had almost 11,000 Covid patients – the equivalent of “22 hospitals’ worth” – compared to just 500 in September.

With a mass vaccination programme unlikely before next year, he said it was essential the spread of Covid-19 was “minimised” to avoid further problems.

“The truth, unfortunately, is that, if coronavirus takes off again, that will disrupt services,” he said.

“We are seeing that in parts of the country where hospitals are dealing with more coronavirus patients now than they were in April.

“The reality is that there is no health service in the world that by itself can cope with coronavirus on the rampage.”

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, said while she was confident the NHS would not “collapse”, non-Covid treatments and operations were at risk.

She said it was important that public support for the health service was not undermined by the spread of misinformation.

“If we don’t have the support of the public in the next wave and we hear rumours and quite frankly lies that are being told in the media, that isn’t going to help anybody,” she said.