The Northern Beaches Hospital has denied it is incapable of performing some stroke and cardiological procedures, saying its contractually obliged not to do so.

The Northern Beaches Hospital has rebutted a Sydney surgeon's accusation the public-private facility is not fully equipped to care for strokes, stating it is contractually obliged to refer some treatments elsewhere.

A NSW upper house inquiry into the hospital at Frenchs Forest, which replaced Manly and Mona Vale Hospitals, began in August amid claims it had "lurched from crisis to crisis" since its 2018 opening.

The inquiry is examining the operation of the hospital including standards of service, staffing and public-private partnership arrangements.

Professor Richard West, a Royal Prince Alfred Hospital surgeon and president of local residents' group The Palm Beach and Whale Beach Association, on Monday addressed the inquiry in Sydney.

He claimed the hospital did not have all necessary equipment to deal with strokes, forcing patients to transfer 13km to Royal North Shore Hospital when rapid treatment should be paramount.

Prof West said he would recommend a relative suffering a stroke go to Royal North Shore as Northern Beaches Hospital may provide treatment too slowly and could not perform thrombolysis, a clot-busting procedure.

"The more rapidly the treatment is given, the better the outcome. The optimum is three hours - by the time they get to Northern Beaches, get investigated and transferred, that time probably will have expired," Prof West said.

However, the hospital on Monday hit back at Prof West's statement, saying it was technologically capable of performing the procedure but advised to refer thrombolysis to specialised "stroke care units".

Director of Medical Services Dr Simon Woods said stroke treatment was centralised around a small number of hospitals due to its complexity.

"It's something that technologically could be done at Northern Beaches but we're advised not to do it," Dr Woods told AAP.

"It states in the contract ... we are precluded from (performing) thrombolysis.

"If we did it, we would be in violation of the contract."

Prof West also told the inquiry it was "appalling" some services, such as heart and brain surgery, were provided solely to private patients. He said this was a violation of contractor Healthscope's agreement with NSW Health.

However Dr Woods said the hospital was contracted to provide a "Level Five" service to public patients - which did not include "Level Six" procedures such as heart and brain surgery - and had fulfilled its obligations.

It was equipped to provide "Level Six" procedures to public patients in the future if its contract with NSW Health was revised, Dr Woods said.

"Healthscope has responded to what it's been asked to do - we do take issue with the concept that we have breached our contract," Dr Woods said.

Prof West said the NSW government should revoke Healthscope's hospital administration role, upgrade the facility to "Level Six", ensure public and private patients can access equal treatment and re-upgrade Mona Vale Hospital.

Australian Medical Association NSW chief executive Fiona Davies later on Monday said her organisation had "cautiously accepted" the decision to place the hospital under a public-private arrangement.

But Ms Davies said the philosophy that initially underpinned operations and guided the hospital planning process had failed.

"We felt that for the public-private partnership to work, the hospital needed to be built on an ideology it was a public hospital being run by a private operator, rather than a private hospital that's treating public patients," Ms Davies said.

"Unfortunately, in the planning stages and initial stages of this hospital, it was apparent that was not the ideology being pursued."

Nevertheless Ms Davies said it was too soon to deem the partnership a failure.