Tamworth Medical Staff Council chair, Dr David Scott, told the rural health inquiry hearing in Gunnedah on Wednesday that of the eight operating theatres at the major rural referral hospital, only five are operational.

The others are empty, used as store rooms or as a place to make a quiet phone call, he said.

The Tamworth-based gastroenterologist told the hearing Tamworth has the busiest emergency department outside of metropolitan areas in the state.

It's also the 'plan B' for every small rural town in the region - almost 200,000 people - but is struggling to cope with the overflow.

"The operating theatres run all day, five days a week - one just for emergency cases not booked, the other four are for the elective procedures and semi-urgent procedures," he said.

"One of the issues is if an ENT surgeon said 'I love Tamworth, I want to move to Tamworth, I've put my kids in school I've bought a house', the hospital, I'm not sure would be able to offer operating theatre time, which for a surgeon is their job.

"I'm not sure whether they would be able to offer them a VMO (Visiting Medical Officer) contract, or a staff specialist contract.

"And certainly the award they would be offered would be identical to the award they'd be offered in the hospital in the next suburb where they're currently offered in Sydney - so there is no incentive to come here - there's no guarantee."

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Dr Scott said currently there is more than enough demand to justify opening the empty theatres, but they also provide a big opportunity to attract new services.

"While we would like to deal with the backlog and people that are waiting, one of the big opportunities to use those theatres would be to get new services to Tamworth such as ear nose and throat, vascular surgery, plastic surgery, more oncology surgery," he said.

"All the things that patients at the moment have to travel all the way to Newcastle for, and while Gunnedah is an hour from Tamworth, Tamworth is four hours from Newcastle or five to six hours from Sydney.

"These are long trips which could be avoided if there were more diversity of local specialists."

Dr Scott was one of 11 witnesses to give evidence at the Gunnedah hearing.

The NSW parliamentary Inquiry Into Health Outcomes and Access to Health and Hospital Services in Rural, Regional and Remote NSW continues.