https://bc.ctvnews.ca/fewer-paramedics-on-shift-as-bc-ambulance-millions-over-budget-1.7169504
Somehow Montreal and especially Toronto have been able to grow into proper big cities. That means the appropriate amount of infrastructure including, emergency services & hospitals, etc...
It's not just this situation, BC hasn't been properly keeping up with a necessary amount of infrastructure over the past several decades.
BC usually seems to have a tougher time getting things done or coordinated well.