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However, the City of Ottawa denies a tentative agreement even exists and says it would never sign off on that kind of arrangement with the counties.

The provincial rule of ambulance “seamlessness” says the closest paramedic unit, regardless of which municipality runs the unit, must respond to the call. When Ottawa Paramedic Service vehicles are tied up in the more populated urban areas, the outside municipalities are forced to cover the city’s rural parts. Ottawa paramedics sometimes respond to areas in the counties.

“It’s a little more complicated than what’s being spouted in the public realm and it’s unfortunate we’re into that now,” Di Monte told Ottawa’s community and protective services committee during a discussion on the 2016 annual report of the Ottawa Paramedic Service.

Michel Chrétien, the head of emergency services in Prescott-Russell, wrote in an email that it’s “not gamesmanship for us.”

Paramedic managers in Ottawa are also under pressure from their political overseers.

Coun. Eli El-Chantiry, who represents the rural ward of West Carleton-March, worries that recent investments by council to hire more paramedics won’t make a difference on the ground after seeing that the service was below the response standard for critical calls in 2016, the second year in a row.

Rural communities are being left vulnerable and the city needs to prove to those residents that they’re not second-class citizens when they deserve the same access to emergency services as urban residents, El-Chantiry said.