Emergency medical services in Canada are the responsibility of each Canadian province or territory. As such, the services, including both ambulance and paramedic services, may be provided directly by the province, may be contracted to a private provider, or may be delegated to the local government level, which may in turn create its own service delivery arrangements with municipal departments, hospitals, or private providers. The approach, and the standards, vary considerably between provinces and territories.
A Rail Ambulance is a vehicle used for medical transportation services on railway lines. The first rail ambulance was set up in 1920, in order to enable injured people to be transported to the nearest hospital, was set up in the coal community of Cape Breton, Nova Scotia. The car ran between #3 and #7 mines and Town of Sydney Mines. It was discontinued in 1922.
In Canada, responsibility for Emergency Medical Services, as a part of health care in general, has been allocated to the provincial/territorial level of government. With the exceptions of British Columbia and Alberta, which operates its EMS services directly, the method used for service delivery will vary to some degree between jurisdictions. Typically, the provincial/territorial government will provide enabling legislation, technical standard, accreditation or licensing, and oversight to a variety of potential system operators, including municipalities, hospitals, or private companies. Municipalities or hospitals may also, in turn, elect to provide EMS service directly, as a branch of another municipal department, such as the fire department or health department, or may contract out this responsibility to a private company. The approaches used for service delivery are governed by what is permitted under the legislation of the individual province or territory, or under the by-laws of a local municipality, when that municipality accepts responsibility for EMS service. Provincial governments may also, as in the case of the provinces of New Brunswick,Nova Scotia, and Prince Edward Island, contract directly with a single private company, Medavie EMS (the same one in these three cases) to provide seamless, province-wide services.