Auditor-General Rod Whitehead reviewed procedures in two departments, anesthetics and surgery and general medicine, across Tasmania's four major hospitals.

"My overall conclusion was the system for rostering specialists has not been effective across the hospital system," Mr Whitehead said.

"We found a wide variety of different practices being used in the way they have rostered specialists in those departments across the four major hospitals.

"They were manually-based systems, using a lot of excel spreadsheets, and in a lot of cases there weren't a lot of controls in terms of changes."

Mr Whitehead said the system of rostering specialists was described to him as a system of trust.

"In having that system of trust, it also means there is a lack of transparency in rostering of specialists in terms of the hours that they work, and in terms of accountability for the hours that they work because very few complete timesheets," he said.

Mr Whitehead said the issue of lack of specialists in the North of the state was referred to him while conducting the review.

"We have indicated that in some cases an absence of specialists can lead to a potential loss of accreditation," he said.

"The North West Regional Hospital and the Mersey Community Hospital are the worst affected."

Mr Whitehead recommended the Department of Health conduct a detailed review of how specialists account for their time to develop improvements.

It was recommended the review consider whether:

"While clinical outcomes are paramount, there needs to be a demonstrated efficiency of time spent in the public system through transparency or rostering arrangements as well as demonstrated fairness to all staff in the medical department or unit," Mr Whitehead said.

Health Minister Sarah Courtney welcomed the report and said it outlined a number of helpful solutions.

"The DHS will now closely examine these findings, including investigating electronic rostering and time management systems," Ms Courtney said.

Labor deputy leader Michelle O'Byrne said she did not think anyone was surprised the Auditor-General was uncovering yet more crisis within the health system.

"If the government has been genuinely been focusing on our hospitals, like they said they have been, nothing in this report will be a surprise to them," Ms O'Byrne said.