Greg Rochford prepared to take the controls of Australia’s Royal Flying Doctor Service (rfds) in 2011 armed with 31 years of public-health experience and a laundry list of fresh ideas on how to better provide healthcare to some of the industrialised world’s most isolated communities. Yet on taking the job he immediately set out to find out more by flying to some of Australia’s most remote outposts: Cape York in the far north, Broken Hill’s mines and the rugged Kimberleys in Western Australia.

This diligent start at the helm of one of Australia’s most iconic brands speaks volumes about Rochford’s management style. He takes tough decisions but is a listener par excellence; a seasoned health professional but one who still defers naturally to the opinions of experts. “Adaptive,” he says, is the one word that best describes his management style. “You have to adjust to the circumstances of the organisation.”

The rfds was founded in 1928 by Presbyterian minister John Flynn to connect rural Australians with healthcare providers; it is the oldest and largest airborne health service of its kind in the world. For all the glamour associated with the brand (popular 1980s mini-series The Flying Doctors was inspired by it) it is a not-for-profit organisation that provides a vital lifeline to people living in the remote reaches of the red continent.

In a country where, Rochford tells us, a mere 0.3 per cent of the population is spread out across 65 per cent of the country’s parched landmass, this is a considerable task. The life expectancy of people living in the outback can be up to seven years lower than corresponding urban populations. More than half of these “excess deaths” are caused by chronic illnesses such as heart disease, strokes, diabetes, chronic respiratory disease and kidney disease. Rochford’s objective is to redress the vast inequity of public services that geography creates. “That’s almost a different social responsibility,” he says. “No one expects to have high-end surgery or even a hospital for some of these communities but I think it’s a pretty fair expectation to be enrolled in a chronic-care programme or let you get your check-up in a timely way so your diabetes is controlled.”

rfds operates 61 aeroplanes, mostly Beechcraft King Air and Pilatus pc-12s that are all medically configured to resemble mini intensive-care units. Each one is pressurised to allow patients to be flown at the equivalent of sea level, essential for the treatment of serious injuries. Overseeing this disparate health service and ensuring that an at-risk population receives emergency relief and adequate preventative healthcare services are highly involved tasks, but they seem well suited to Rochford’s technocratic management philosophy. “It’s an expert-driven industry and you need access to experts,” he says, “but you can’t make decisions based on being liked.”

You can, however, make decisions based on experience. In many ways, the national chief of the rfds is a dream job for Rochford, who has spent a lifetime in health services across Australia. After leaving his native New Zealand to travel he completed degrees in law and criminology before embarking on a distinguished career that culminated in his previous position as head of the ambulance service for New South Wales, Australia’s most populous state. Although Rochford likes to claim that his education came from the “school of hard knocks”, he has the nous to run an operation whose more than 1,000 staff flew over 27,000km to reach more than a quarter of a million patients in 2011.

Rochford’s office in a high-rise a few streets away from the Sydney Opera House is spartan. A plain desk and round meeting table anchor the room and three prints by Aboriginal artists look down from the otherwise bare walls. There is only a handful of staff working out of the Sydney HQ, which looks as if it has not seen a significant renovation since the days when wide collars and gold chains were considered office-appropriate attire. But the décor reflects the laid-back yet cerebral demeanour projected by the slim 53-year-old at its helm, who says he takes full advantage of the quiet moments afforded by a small office to focus on big ideas. “You get plenty of good thinking time, which is a real luxury.”

Rochford is also set on expanding remit into other healthcare sectors. He believes that the future of the rfds’ organisation lies in building a complex network of partnerships with private and public hospitals to provide services such as inter-hospital transport, which allow it to fund the activist work for which it is known. “In many regional locations that’s all we’re doing: moving patients from hospital to hospital and sometimes moving providers around,” he says. “That’s a competitive market: most big hospitals contract that work out so we bid for it. Doing that work builds our core infrastructure and it’s from that infrastructure that we’re able to deliver those incredibly low-volume services to very remote communities.”

From Sydney, Rochford’s job is to coordinate the regional offices that are responsible for day-to-day operations; his adaptability model has been stretched at the rfds far more than in any of his other posts. “The ethereal world of ceos, where you can just kind of float like a bubble on top of the team of experts, doesn’t necessarily apply to a not-for-profit organisation and it certainly doesn’t apply to remote healthcare,” says Rochford with a knowing chuckle. “That was my learning curve.”