A commission of inquiry has been told there were "catastrophic failures" by the Launceston General Hospital in responding to complaints and red flags about former pediatric nurse James Geoffrey Griffin.
Griffin took his own life in October 2019 after being charged with multiple child sexual offences.
Peter Renshaw, who has been executive director of medical services at the hospital since 1989, was asked by counsel assisting, Elizabeth Bennett SC, if processes had changed since Griffin's offending became known.
"I'm not certain that there have been any marked changes," he replied.
Dr Renshaw was asked how he could be sure the hospital was safe and replied, "I can't really answer that".
"Did the hospital learn anything from the experience of having Griffin operating on a children's ward for 18 years? Where do we find those learnings reflected?," Ms Bennett asked.
"I can't answer that question. I don't know where. I certainly know the experience has been a great teacher. There will be leanings that we get from the commission that we will be able to use," Dr Renshaw replied.
The inquiry was called by the state government in late 2020 after whistleblowers and survivors told their story through a podcast and the media.
Dr Renshaw conceded it was an error that a briefing from the hospital to the health department boss in November 2019 didn't reference a historical abuse allegation against Griffin that he knew about.
Dr Renshaw said he was told in October 2019 by police that a colleague of Griffin, Kylee Pearn, told hospital human resources in 2011 that Griffin had abused her as a child.
The inquiry was told Dr Renshaw was told by police in July 2019 they were investigating allegations Griffin abused a child under 12 who had been a patient at the hospital.
He was also told child exploitation material found in Griffin's possession may have been taken at the hospital.
The briefing said police had advised there was no evidence to suggest any criminal activity had taken place within, or connected to, the hospital.
Department of Health secretary Kathrine Morgan-Wicks, who received the briefing, said she was horrified to learn she was misled.
"I feel (it was) designed to reassure me that there was nothing to see here in terms of the (hospital)," she said.
Dr Renshaw agreed it was open to the commission to find there had been a failure of leadership at the hospital following Griffin's death.
"This was an absolutely unprecedented situation. We muddled through but it was not ideal," he said.
"Probably what we could be criticised (for) was not being dysfunctional, but being not resilient or not flexible enough to try and work out better ways of ensuring the safety of children in the hospital as a result of this experience."
The inquiry, which will hand down a final report in May, will hold its final two days of hearings next week.
