On Tuesday evening, the NWT government set out what it said was a comprehensive list of problems dogging the new Stanton Territorial Hospital.
Staff have for months complained of waste-water leaks, temperature problems, and mould, among other issues. The hospital cost $350 million to build and opened in May 2019.
Senior healthcare officials on Tuesday presented to MLAs a lengthy account of the problems.
Concerns documented included inadequate provision of food, poor cleanliness of rooms, problems with water pressure, toilet overflows, water leaks, and cold air entering the building in extreme conditions.
Spring 2020 looks to be a critical time for the hospital, with a number of critical repairs and investigations set to take place as the weather warms.
Officials stressed private contractors, not the NWT government, are responsible for the cost of repairs.
They also admitted the new hospital had placed an unfair burden on existing staff, "overworking many people."
Dexterra, the contractor providing services to the hospital, was said to have "underestimated' the number of employees it needed to keep the building running.
Dexterra upped its hiring – including a plumber and a "dramatically increased" housekeeping staff – in a bid to solve problems.
The NWT government pays the consortium responsible for operating and maintaining the building, Boreal Health Partnership, approximately $1.8 million per month – which includes a debt servicing payment. Boreal in turn pays Dexterra.
Officials said they had no knowledge of the profit margins Boreal and Dexterra enjoy under that agreement.
'A breaking-in period'
Contractors had been docked $500,000 in penalties for problems up till December, said Gloria Badari, executive director of Stanton renewal (the NWT government's name for moving to the new hospital).
"All facilities have a breaking-in period. Even the most rigorous testing of a building won't replicate the day-to-day use," said Sue Cullen, chief executive of the NWT's health authority. "It wasn't until the full patient load that issues began to materialize.
"Throughout this period, staff continue to highlight issues [but] we are starting to see issues diminish over time."
Tuesday's briefing was delivered to a committee of regular MLAs chaired by Tu Nedhé-Wiilideh MLA Steve Norn. The briefing did not involve government ministers.
Kim Riles, the hospital's chief operating officer, announced last month she is leaving her position.
Riles, who remains in post for the time being, opened Tuesday's briefing by listing the hospital's qualities and some successes – such as adding a traditional foods coordinator and full-time resident Elder.
However, the evening focused on the facility's failings and their impact on staff and patients.
What went wrong
Badari ran through the following list of concerns, in red. Fixes mentioned by Badari are shown beneath each item.
Problems with food included meals with the wrong texture (which could lead to patients choking); food-ordering software that was "not as ready as we had hoped;" and dietary requirements, for example for diabetic patients, that couldn't be met.
Dexterra hired a local dietician to help fix the problems alongside many more food service staff, plus a supervisor.
It took a long time for rooms to be cleaned, there wasn't enough clean linen, and garbage at the hospital was not emptied regularly.
Dexterra hired many more housekeeping staff and supervisors.
Hot water "was a struggle throughout the building" with poor water pressure on the fifth floor; temperatures could be too hot or cold for hand-washing; and problems were at their worst in the mornings, when patients tried to take showers and laundry was being done.
Dexterra added a plumber and hired contractors to look at problems. Two new pumps will be installed in the spring.
Toilet overflows were reported throughout the building. Sometimes "inappropriate material" had been flushed while in other cases the problem was construction material like rocks and gravel in the drains. Some toilets had no slope or back-sloped drains.
Dexterra has contracted a company to investigate, and drains with no slope or a back-slope are being fixed. Contractors are clearing out other drains.
There were 35 water leaks reported by mid-January. The NWT government said most had a "minimal impact," though a leak came through the roof around Christmas. Some of the roof venting turned out not to have been fully sealed.
Dexterra is working with contractors to repair the roof. A full inspection will take place in the spring.
Cold air is being sucked into the building during extremely cold weather. Metal exterior doors are also frosting over.
Dexterra has resolved some issues with air supply to the building and will investigate further in the spring. An additional heater has been placed at the emergency entrance and sets of sliding doors have been re-sequenced to better keep out the cold.
'We never learn'
Badari stressed that, for the next 30 years, contractors must cover the cost of all repairs for issues such as these.
During that time, the NWT government is only liable if damage is the result of "misuse or negligent act of staff or the facility users."
Cullen, the health authority boss, said there are "regular committees" with Boreal Health Partnership and Dexterra to review issues and work out solutions.
A group of NWT government executives also holds regular internal meetings to review the situation, she said.
"We always ask what we can learn," said Hay River South MLA Rocky Simpson, referring to public-private partnerships (or P3s) like the new hospital. "We never seem to learn."
Simpson said he refused to believe the NWT government had not incurred additional costs during the hospital's struggles.
Cullen acknowledged that while there were no additional repair costs paid by the territory, there were extra costs "as a result of us working collaboratively through those initial issues" – for example, the cost of additional staff hours.
The total of those costs was not given. Sandy Kalgutkar, the deputy minister of finance, said he believed the NWT government would "attempt to recover" that money.