There is certainly a case for scoop and run but it really depends on what you mean by 'definitive care.' If you mean getting patient with head injury to definitive care (i.e. somewhere with a neurosurgical facility) then a paramedic in a helicopter travelling in a fast, straight line is a good idea whatever their basic qualification. Depending on how that paramedic is trained, they can value add treatment enroute to make the patient's recovery/survival that much better. I suppose that's where the education comes in and hopefully a robust governance system to support the clinician and crew.
I came into the ambulance service at a technician/certificate level and I have seen the current flock of degree student paramedics struggle with attempting to apply their advanced knowledge to the vast majority of ambulance work which doesn't need anymore knowledge than how to depress the accelerator on the ambulance. So, a degree education may not be needed for the vast majority of work but it certainly helps when you're operating on the rarer case presentations that paramedics find themselves with now and again.
I currently work in HEMS environment with a permanent paramedic/doctor system delivering up to a full anaesthetic capability. I'm certainly no where near educationally than the doctor is but then I'm employed for my general pre-hospital experience to enhance the team. I would not propose a similar system for SAR although I am sure it would benefit patient care. The ability to deliver definitive care in the back of a helicopter is extremely difficult but not impossible so most of our interventions are done before packaging and transfer so that the helicopter can be used for what it was designed for--a versatile and fast(ish) transfer platform.
I wonder how the argument would go if the pilots only required a PPL to fly SAR helicopters? Education does have a place, it's getting the balance right to give the best service to the user and allowing the practitioner to intervene in a safe and responsible way.
take care all,
ropes