The Welsh Assembly has rejected a call from the Conservatives to scrap the country's 22 local health boards (LHBs).
Health minister Edwina Hart said the Labour-Plaid coalition is determined to eliminate the internal market from the NHS.
She had hinted at a possible rethink of the existing set up because an excess of health commissioning bodies was leaving some patients "lost in the gaps".
But she has rebuffed the idea from the Tory Party for a single body to plan and pay for health services across the nation.
The opposition had called for an "arm's length" organisation that would take over the running of the health service.
Shadow health minister Jonathan Morgan said Wales has no need for "22 mini health authorities", and that smaller LHBs cannot negotiate with large hospital trusts.
But Mrs Hart said LHBs need to "speak with one voice" when dealing with trusts.
She added: "I am determined that we will remove the last vestiges of the internal market here in Wales.
"We do want to get rid of the purchaser-provider split and we will have to look at ways to undertake that."
Copyright © PA Business 2007