The government has again been called upon to develop regulations around out-of-home care in Tasmania after it was first demanded two years ago.
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Children's Commission Leanne McLean on Monday released a report on out-of-home care and noted there was no overarching quality and accountability framework for the system.
She said Communities Tasmania was in the process of developing one, however.
"It's time now that we move that work to an implementation phase," Ms McLean said.
Regulation of the out-of-home care sector was recommended in a report by former Children's Commissioner Mark Morrissey two years ago.
Ms McLean said improvements needed to be made to health records of children in care and how that information was made available to non-government care providers.
She said children in out-of-home care should be prioritised in the public health system and on hospital waiting lists.
Ms McLean said there was a 21-per-cent increase in young people entering out-of-home care arrangements over four years in 2018.
There are 1327 Tasmanian children in the system.
"The number is growing, children are coming into out-of-home care earlier and they are staying in care longer," Ms McLean said.
"That increases the government's responsibility to have a system that looks after children and that is quality assured."
She said six young people over the time the report was compiled were in out-of-home care in the Northern Territory because "the same care experience could not be offered in Tasmania".
"We should establish a similar type of care arrangement in Tasmania," Ms McLean said.
She said carers need to be appropriately trained to ensure they had an understanding of Tasmanian Aboriginal history and culture.
Greens leader Cassy O'Connor said there was no evidence big investment to reform the child safety system had resulted in better outcomes for children.
"We've got vast public resources going into the out-of-home care system and yet this government has no real program for monitoring and oversight of those children," she said.
Labor's Josh Willie said it was "deeply concerning" the out-of-home care system in Tasmania was unregulated.
"It is quite clear from this report that the government is not providing timely oversight for children and young people (and) not preparing for their futures," he said.
Deputy Premier Jeremy Rockliff said the government would work with the Children's Commissioner to implement a number of the recommendations.
He said the report showed more improvements needed to be made to the system but work to do so was underway.
