Scott Morrison has indicated it is possible that asylum seekers with serious medical emergencies will continue to be treated in Australia, while taking a pool of reporters to Christmas Island to showcase the facilities the government has reopened at an estimated cost of $1.4bn over four years.

The prime minister led reporters on a tour of the Christmas Island facilities on Wednesday. When pressed about why he was on the remote island, with reporters in tow, for what was self-evidently an expensive public relations sortie, Morrison declared it was “important for Australians to know this facility is up to the job”.

He said it was important to send a message to people inclined “to game the system to come to Australia using these loopholes”.

But when reporters asked whether people would continued to be treated in Australia, as they have been under existing arrangements, despite the rebooting of the Christmas Island facilities, Morrison replied: “In the normal cases where people are requiring significant health treatment, I mean, those cases were already dealt with under the previous arrangements”.

“Where people needed that care, they were getting that care,” the prime minister said.

Asked if that meant people would continue to be transferred to facilities like the Mater hospital in Brisbane if they were seriously ill, Morrison said “that depends” but he also said there would be no change to existing procedure.

“It is a case by case assessment by the medical teams which have been in place for years. There is no change to those arrangements.”

Recent evidence given to a Senate estimates committee suggests 898 people – unwell asylum seekers and their family members – have been transferred to Australia for medical treatment under arrangements in place for the past five years, and remain on the mainland.

Officials reported 1,246 people had been transferred “over a period of time” and 282 had been returned to offshore detention.

Scott Morrison tours the detention centre on Christmas Island where refugees will be processed if they are approved for medical transfer. Photograph: Lukas Coch/AAP

Since the passage of the medical evacuations legislation in the last parliamentary sitting period, the government has sought to characterise the change to procedures governing medical transfers as a critical threat to the border protection regime because the changes will create fresh incentives for people to try to get to the mainland.

When it was put to him on Wednesday that the public relations sortie on Christmas Island could be interpreted as an advertising exercise, or as an overt dare to people smugglers to restart their trade, Morrison portrayed himself as a “brick wall” when it came to people smugglers, and the Labor leader, Bill Shorten as an “open door”.

Despite the new legislation specifying explicitly that any person sent to Australia for medical treatment would need to remain in detention for the duration of the transfer, Morrison emphasised that Christmas Island was a “hardened facility” that could deal with high-risk transferees.

The government says the high-risk cohort, who could apply for medical transfers, is around 60 people.

While the medical evacuations bill is now in force, the government has not yet put together the expert medical panel that is at the centre of the new arrangements.

Guardian Australia revealed last month that the Royal Australasian College of Physicians had raised problems with the government about the panel established by the medical evacuations bill, including the lack of remuneration for medical experts appointed to the new body.

The new system establishes an independent panel made up of the commonwealth chief medical officer, the home affairs department’s chief medical officer, and at least six others including a nominee of the president of the Australian Medical Association, of the Royal Australian and New Zealand College of Psychiatrists and of the Royal Australasian College of Physicians, and an expert in paediatric health.

The independent panel will be required to review decisions within 72 hours if the minister refuses to allow a transfer on health grounds. If the panel says it should proceed, the minister can refuse if the transfer is considered prejudicial to security, or if the person has a substantial criminal record.

After a high-stakes wrangle in the parliament, where the government flagged a potential constitutional problem with the bill, the legislation was amended to specify that people on the new panel will not be paid for their contributions. That amendment was inserted to avoid a potential breach of section 53 of the constitution.

Morrison said on Wednesday the panel was “still being formed”.