Representatives of the Yukon Hospital Corp. appeared before the legislative assembly as witnesses Monday, for the first time since 2010.

The official Opposition dominated the questioning. The NDP raised issues from the new hospitals in Watson Lake and Dawson City to the potential for bringing dialysis services to the Yukon and maternity care to the new community hospitals.

Both Craig Tuton, who chairs the hospital corporation's board of trustees, and Jason Bilsky, the corporation's CEO, appeared before the MLAs.

In an opening statement, Tuton noted the territory saw a five per cent population increase between 2009 and 2012.

That includes a 13 per cent increase in those over 50 years old, and a 22 per cent increase in people over 65.

Those over 50 are the highest users of hospital services, Tuton said.

He highlighted an associated increase in surgeries (up 32 per cent), specialist visits (up 48 per cent), chemotherapy treatment (up 31 per cent), and emergency room visits (up 29 per cent).

Tuton also addressed the status of the new community hospitals.

The Watson Lake Hospital is planned to open this summer at a total cost of $27.9 million, which accounts for equipment costs, capital interest, and unanticipated change costs.

It was originally scheduled to open in the spring of 2012 at a cost of $22 million, which did not consider the cost of equipment nor capitalized interest costs.

The Dawson City Hospital is planned to open this fall at a cost of $31.8 million, also accounting for equipment costs, capital interest, and unanticipated change costs.

It was originally scheduled to open in the fall of 2012 at a cost of $26.5 million, which did not consider the cost of equipment nor capitalized interest costs.

Both hospitals will open and run, at least initially, under a traditional model of care. Both opposition parties have repeatedly questioned this decision, recommending a collaborative model instead.

In Dawson, the decision to move forward with a traditional model of care impacted several extended scope nurses working at the local health centre.

"At the time of planning, research indicated there were no Canadian hospitals using a model where nurses with expanded scope were the primary caregivers,” Tuton said.

He noted the corporation is considering the recently adopted nurse practitioners legislation, and there is an option to transition to an alternate model of care in the future.

Tuton assured the MLAs he expects both hospitals to be fully staffed in time for opening.

The current Watson Lake Hospital is already fully staffed, but the community is facing a severe doctor shortage. Physician recruitment is ongoing.

In Dawson, the situation is reversed. The community is comfortable with its number of doctors, but recruitment is ongoing for other hospital staff.

Tuton and Bilsky will be in Watson Lake Wednesday to update the community on the progress of their hospital. They plan to travel to Dawson to do the same soon after.

Jan Stick, the NDP's Health and Social Services critic, noted the hospital corporation committed to conduct a more comprehensive needs assessment for both new hospitals.

"I stress that because I heard from the witness that they are going to the communities to bring them up to date on what the hospital corporation has decided,” she said.

"That's public awareness; that's public education. That's not consultation; it's not assessment to ensure that what the community is asking for is how appropriate decisions are being made.”

Tuton also addressed the construction delays caused when the general contractor, Dowland Contracting, defaulted on both contracts.

The bonding company has agreed to complete the contract for the agreed price and timeline, he noted, and that work has resumed on the projects.

"This situation was completely unforeseen and out of the Yukon Hospital Corporation's control. However, having said that, the corporation took immediate action to protect the best interest of the corporation and most importantly, of the subtrades working on those projects,” said Tuton.

In response to the NDP's questions, Bilsky explained the corporation first became aware that Dowland was failing to pay subcontractors, when the subtrades began leaving the job.

Stick said she is aware of subcontractors still awaiting payment of around $1 million.

There is a process underway to confirm the work subcontractors are invoicing is actually complete, Tuton noted.

Bilsky confirmed $1 million is in trust for payment to the subcontractors.

Stick also questioned the significant increases in operating costs compared to the facilities previously in operation in both communities.

In Watson Lake, operation and maintenance costs will rocket from $3.4 million to $9.2 million, while in Dawson, they surge from $2.7 million to $9.3 million.

Bilsky said the increases account for staff salaries, maintaining and operating supplies and equipment, and as interim Liberal leader Sandy Silver later noted, debt servicing.

"To clarify, just as an example, Watson Lake is not just the operations of the hospital; it's a much larger health facility that is being operated there, so to compare apples to apples, you have to include all the costs,” Bilsky noted.

There was further discussion about the planned expansion of Whitehorse General Hospital's emergency room, planned for completion in 2017, and the construction of a facility to house an MRI machine, planned for completion by 2014.

The cost of the ER expansion is estimated at $60 million, with a further $1.5 million to replace the existing ambulance station.

Silver questioned whether the corporation has completed a needs assessment for the Whitehorse hospital expansion, something it failed to do for either community hospital.

The Whitehorse facility was completed fewer than 20 years ago, replacing a 1950s-era building on the same site.

Tuton said an assessment had been completed when the corporation went through its master planning with Stantec in 2011.

The NDP also raised questions about the possibility of bringing kidney dialysis services to the Yukon – something the N.W.T. has in several communities.

Tuton said it's something that is regularly discussed but at this point, the volumes don't support developing a dialysis program.

It's a similar issue to the provision of maternity care in the communities.

When Stick pushed on the maternity question, Bilsky explained that birthing has become more complex as women have children later in life.

He said there have to be redundant systems, like operating rooms, in place and staff specialized in maternity care.

It doesn't mean it won't be considered in the future, but at the moment, it's too expensive to provide at the community hospitals.

The hospital corporation is scheduled to appear before the legislature's public accounts committee next month with regard to the federal Auditor General's report on its management of capital projects.