The rising burden of chronic disease in Australia has put the health system under great pressure. A system largely designed to cope with short bursts of acute illness via hospitals and general practitioners now has to deal with more chronic illnesses. The ageing population means there are more people faced with the slow decline of physical and mental function, and the distress and bewilderment that can bring. Consequently, the health system and the community generally need to focus on social support as well as medical problems. One health policy response has been to call for stronger patient engagement. This means patients know more about their condition and have the confidence to manage their illness at home and make informed decisions. Patient engagement is recognised as a central point in most chronic care models, often described under self-care, self-management programs and self-management support. It makes sense for governments trying to keep health systems financially viable, and for patients and carers wanting more control over their lives and health. Health literacy underpins patient and carer engagement and facilitates informed decisionmaking and self-management ability.