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Scott Morrison has warned that child molesters, rapists and murderers could come to Australia if laws around evacuating sick asylum seekers from offshore detention are changed.
But Labor has rejected the suggestion as shameful scaremongering.
The prime minister declared "hundreds upon hundreds upon hundreds" of single men will be sent to Australia if Labor supports the changes in parliament next week.
Mr Morrison said the legislative amendments would give any two doctors the final say on who comes to the mainland for medical treatment.
He claimed the bill would also stop the government from rejecting medical transfers to asylum seekers with criminal histories, despite supporters of the bill insisting these protections would remain in place.
"They may be a pedophile, they may be a rapist, they may be a murderer, and this bill will mean that we would just have to take them," Mr Morrison told reporters in Melbourne on Wednesday.
"This is what will happen if Bill Shorten does not put national security ahead of his own political opportunism."
Mr Morrison issued a blunt warning to Mr Shorten: "If you break it, you own it."
Mr Shorten told reporters in Townsville, where he was inspecting flood damage, the prime minister should be "ashamed of himself".
"The fact of the matter is people who have done those crimes don't get the refugee status unless the government's missed them when they've assessed them as refugees," he said.
"The idea that somehow because you're a Liberal you dislike those crimes more than if you're someone else, I just get sick of that moral superiority and finger pointing."
A private member's bill being driven by Wentworth independent Kerryn Phelps would give doctors - rather than politicians and public servants - the final say on medical evacuations of sick asylum seekers.
Labor supports the legislation, which is expected to be voted on as early as next week.
The Morrison government risks becoming the first in 90 years to lose a substantive vote in parliament, which would be widely seen as a loss of confidence.
But the prime minister insists the likely defeat will not trigger an early election.
"No, of course not, why would it be?" he said.
Earlier, Mr Morrison vowed to ignore the vote on the "stupid bill" that he argued was "written by people who haven't got the faintest idea how this works".
Mr Shorten said the comment showed the prime minister had given up on governing.
"If you've got a prime minister that says he doesn't care what parliament says, well why are we waiting to have an election in another three months?" Mr Shorten said.
Cabinet minister Matt Canavan explained the prime minister was simply saying he would "get on with the job" if the vote was lost, rather than calling an early election