Jill Ludford and the leadership that grows people, places and systems. Photo: Courtesy of NSW Health.
There are leaders you appoint. And then there are leaders who grow into the role — shaped by place, people, pressure, and time.
Jill Ludford is unmistakably the latter.
After more than three decades in NSW Health, including 11 years as CEO of Murrumbidgee Local Health District, Jill has announced her retirement. Words feel inadequate, but reflection feels necessary.
I have known Jill since 2011, first when she was director of operations for MLHD, and later as CEO from 2014 onwards. Over those years, I have worked alongside her as a clinician, member of the district clinical council, an executive in her team, and now as a board director.
That long arc has given me a privileged vantage point on what real leadership looks like in rural and regional Australia.
I have also had the opportunity to stand beside her while visiting multiple health services across the district. What always struck me was her ability to give genuine attention to every calibre of staff — from frontline workers to senior leaders. She loved listening to personal stories. She understood that stories carry truths that dashboards never will.
Yet she also knew exactly how to translate those stories to the highest levels of the system. That rare ability made her more than a leader for Murrumbidgee. Jill is recognised as a formidable voice for rural and remote New South Wales. Many sought her wisdom. Many rely on her guidance.
In 2016, Jill established the MLHD district clinical council. She wanted grassroots clinician voices at the table, not as an afterthought, but as a core input to leadership. I was fortunate to be one of the inaugural members.
Jill was a natural collaborator and a skilled negotiator, but above all, she led with an unwavering commitment to our region. She cared deeply about the far corners of the Murrumbidgee — the towns that don’t make headlines, the services that are easy to overlook.
That philosophy came to life most powerfully in the Murrumbidgee Rural Generalist Training Pathway. In 2018–19, I had the privilege of working closely with Jill on what became a nationally recognised, first-of-its-kind rural generalist training model. MLHD was the pilot and pioneer site.
Our bold regional experiment is now the prototype adopted across all states and by the Commonwealth.
In 2019, under Jill’s leadership, I was appointed the first director of primary health care in MLHD — a role that did not exist in any LHD in NSW. That decision reflected her foresight: that genuine integration with primary care was essential for rural systems to thrive.
A particular note must also be made about Jill’s relationship with the Primary Health Network. Jill has been a close friend of Murrumbidgee PHN. That partnership was never symbolic or transactional — it was genuine.
It is no secret at state and national levels that collaboration between Murrumbidgee LHD and the PHN operates at a different level. Many PHNs across the country do not enjoy the privilege of what we have in Murrumbidgee. This work has attracted national accolades and praise — because it worked.
As the current chair of the Murrumbidgee PHN, I want to place on record our deep gratitude.
Jill understood that strong hospitals need stronger primary care — and that strong primary care needs a health system willing to partner, not control. She had respect towards rural GPs and allied health clinicians and leaned into collaboration with generosity of spirit.
On a more personal level, I remain deeply grateful for the opportunities Jill gave me to grow. At a time when international medical graduates were too often looked down upon rather than invested in, Jill was a passionate supporter of my work in Finley. She had the foresight — and the courage — to extend trust, opportunity, and support, not just to me, but to what our whole region could become as a result.
These things don’t happen by accident. They happen when a leader understands workforce not as a problem to be managed, but as people to be grown. That kind of leadership changes lives. And it changes systems.
In 2020, I joined the MLHD Board. Our discussions were robust, thoughtful, and often challenging — exactly as they should be. Jill welcomed that.
What I will miss most are the late-night conversations about local issues. The careful guidance. The seriousness with which she carried responsibility for communities that trusted her leadership.
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To lead an organisation with a budget nearing $1 billion and more than 30 healthcare institutions across a region twice the size of Tasmania is extraordinary.
Yet what truly set Jill Ludford apart was the humility with which she carried that responsibility. Despite the scale, she always made time to connect with small organisations and frontline staff, understanding that real leadership is measured not by the size of your remit, but by your willingness to listen and invest in every part of your community
Every good thing has to end. That is life. And leadership, too, must be relinquished at the right moment. Letting go at your peak takes courage. Jill has done exactly that.
She leaves MLHD in good hands, having deliberately nurtured the next generation of leaders around her. But let’s be honest: a Jill Ludford in the making will take decades — perhaps longer.
We will only truly understand her impact when we realise what is missing.
Jill, thank you for flying the rural flag when it mattered most. Thank you for believing in clinicians, in rural, and in possibility in rural. Thank you for showing us that leadership is not something you are given — it is something you become.
This may be the end of your CEO chapter, but knowing you, it is not the end of your contribution to Murrumbidgee.
With gratitude, respect, and deep admiration.
Associate Professor Alam Yoosuff is a rural generalist GP, chair of the Murrumbidgee PHN, and a board director for the Murrumbidgee LHD. He is a clinical academic at the University of Notre Dame.
This article was first published on Professor Yoosuff’s substack. Read the original here.