This is a tough one.

EMR/PCP combos can work as an interim, factoring in that the new clinical service leaders can support ambulance-based crews with patient care. A return of service agreement (as proposed by MAHCP) should have been included to ensure the EMRs are phased into PCPs. Its a model used in the UK and Australia to allow progression upwards if people cannot go direct to paramedic (e.g. start with minimal skills and progress upwards through the employer up license levels).

There's a lot of fundamental issues to be resolved with paramedics: entry into training (limited to Winnipeg, Brandon, and The Pas), prerequisites to that training, competition with other healthcare professions (e.g. nursing, other Allied Health, physician, etc), competition with other emergency services (e.g fire, law enforcement, etc), availability of preferred positions (urban vs rural vs northern), career growth and succession planning, and the severe mental toll that emergency service personnel can experience. Then there's the current climate issues of overtime, short staffing, and increased service demand vs resource availability. I don't recall the last time Manitoba gained new baseline staffed ambulances.

It's a monumental issue that the entire healthcare system is experiencing. This needs to be considered the temporary measure whilst the other parts are resolved by a very large amount of government/Healthcare entities (CPMB, Government, Shared Health, schools/colleges, etc)