The landmark US healthcare reform bill must be sent back to the House of Representatives for approval after two issues were raised by Republicans.

During an all-night voting session, two points relating to student loans were found to violate Senate procedure, said an aide to the Senate majority leader.

They were described as “relatively minor provisions”.

They will have to be deleted, approved by the Senate and then sent back to the House for approval.

The bill was passed in the House of Representatives by 219 votes to 212 on Sunday, with no Republican backing.