While under municipal government control, it is subject to provincial legislation and licensing. The City of Toronto has operated an ambulance service directly on an uninterrupted basis since , when the City of Toronto Health Department acquired two ambulances to transport those with infectious diseases to the local sanitarium.
Full-time emergency ambulance service began in , with the provision of emergency ambulance service by the Toronto Police Force , which eventually operated four horse-drawn vehicles. This 'broad spectrum' approach to service delivery would continue for more than ninety years.
Toronto may very well be able to claim to have the first formally trained 'ambulance attendants' in North America, with the Toronto Police Force ambulance service staff receiving five days of formal training in their jobs from the St.
John Ambulance Brigade in Such training for ambulance attendants was unheard of at that time, outside of military circles. The police constables assigned to the ambulance also did regular policing , when not required for ambulance calls.
As the city grew and technology progressed, so did the ambulance service. The first motorized ambulance was actually purchased by a local funeral home in , and the Toronto Police Ambulance Service began the conversion from horse-drawn to motorized vehicles in , with the process largely completed by Over the years, the two City of Toronto departments would have their services supplemented by more than individual ambulance operators, most of them private companies, and in suburban areas by several of the tiny, local fire departments.
