The application includes an endorsement written on NSW Health letterhead signed by one of the hospital’s doctors which says, “This sum of $500,000 would be spent on much-needed medical equipment in the Children's wards at Fairfield to better service the families of the Fairfield Local Government area. On behalf of the Children and staff at Fairfield Hospital, I wish to thank you for your enthusiastic support and generosity which amply defines the spirit of kindness, caring and compassion for children and their families at a difficult time.” Dr John Crozier, a surgeon who is also chair of the Trauma Committee of the Royal Australian College of Surgeons, said news of the deal had caused significant anger among some clinical staff. He said doctors that worked in the area were aware of the significant harm caused by poker machines, which are understood to not only contribute to poverty but also domestic violence and are related to high use of alcohol and smoking rates. He said the machines were known to have an even more significant impact on people with mental health conditions including depression, anxiety and schizophrenia. “The psychology behind these machines is quite chilling. People do a lot of harm to themselves while in a state of mania.”

He said the full impact was not fully understood in NSW because it was not properly studied. Dr Crozier said it was “obscene and perhaps even a breach of the code of conduct” for doctors serving the community to be helping a local publican to increase the number of poker machines in the area. Dr Andrew McDonald, the former shadow health minister and an associate professor of paediatrics at the University of Western Sydney, said he believed the doctors who supported the bid were well intentioned but naive and had been taken advantage of by “cowboys”. Fairfield is one of the poorest local government areas in the state, as well as an area with among the highest densities of poker machines and gambling rates per capita. Residents put $8.4 billion through the area’s pokies in 2017, an increase of 20 per cent over the previous year.

Experts estimate half of all money lost on poker machines in NSW is by people with an addiction to gambling. Loading Because of the high number of machines in the area new applications must be accompanied by evidence of an associated social benefit under state government regulations. The Sun-Herald has previously reported on the application by the Fairfield Hotel when other charities declined to accept donations associated with it. "There was an irony in the fact that he wanted to support our youth club whilst damaging the health of those kids' parents through actively promoting a reduction in household income through gambling," Jason Cummings, the former director of one local charity, Community First Step Mr Cummings said at the time.

At the time it was not known among the medical community that some doctors had backed the bid. It is understood that the Department of Liquor and Gaming has yet to make a decision on the application. A spokesperson for the South Western Sydney Local Health District said it was aware of the 2017 request to support a local impact assessment application. "Staff have been advised that we do not support these requests," the spokesperson said. The Fairfield Hotel has been contacted for comment.