The Commission of Inquiry into the Tasmanian Government's Responses to Child Sexual Abuse in Institutional Settings held its first hearing on Tuesday.

It was set up by the state government in November after abuse allegations were levelled at Ashley Youth Detention Centre staff and former paediatric nurse James Geoffrey Griffin.

Counsel assisting the inquiry Maree Norton said the commission was aware of allegations of abuse occurring at the centre from 1970 to now.

She said there was evidence of multiple perpetrators among staff and that older children had sexually assaulted younger detainees.

"It has also been alleged that staff at Ashley have covered up the abuse, they have destroyed records or failed to report abuse at all," Ms Norton said.

Ms Norton said there was an incongruence between complaints of abuse at Ashley made to the commission and complaints made to oversight bodies.

She said this pointed to a "significantly higher" level of abuse than what has been reported.

"It might also be that there has been deliberate cover-up," she added.

Premier Peter Gutwein in September announced the facility would be closed within three years and a new model established, but insisted children currently kept there were safe.

"In the course of the coming three years, more children will be placed there. Without change, three years may be too long a time," Ms Norton said.

She said Ashley's role as a major regional employer appears to have contributed to it remaining open despite "many reviews over many years" identifying concerns about the safety of children.

The inquiry, which will hold public hearings in February and March, has obtained 21,000 documents from government and individuals, and received 111 submissions.

Ms Norton also said the state government has made slow progress in introducing key reforms recommended by the national royal commission into institutional child sexual abuse.

She said limited progress has been made on the introduction of a reportable conduct scheme and the implementation of the national principles for child-safe organisations.

"The consultation phase for the legislation was completed in February this year but legislation is yet to be tabled in parliament," she said.

Griffin took his own life in 2019 after being charged with a string of child sex offences from his time working at the Launceston General Hospital.

Several alleged female victims are suing the state's health system for damages.

Tasmania Police offered a public apology in February after an internal review revealed they received complaints about Griffin in 2009, 2011, 2013 and 2015.

A lack of information sharing between child safety services and police was to blame for one allegation not proceeding further.

Ms Norton said allegations of sexual abuse at the hospital did not appear to be limited to Griffin.

She said complaints may have been ignored or not dealt with appropriately, and there were allegations of similar patterns of abuse at the Royal Hobart Hospital.

The inquiry is due to deliver a report in August and will examine abuse allegations in schools, the health and justice systems, as well as out-of-home care.

"Some people have expressed hope and optimism about this inquiry. But others have expressed weariness about yet another review," Commissioner Marcia Neave AO said.

"We're aware of an understandable degree of cynicism about the appetite for genuine change.

"It is my hope that this commission of inquiry is not just another inquiry to be filed away and collect dust."

Australian Associated Press