Australia has long been an innovator in consumer participation in health with governments over 30 years responding to the desire of community members to be involved in policy making around health. The current complexities, stresses and changing demands in health policy make it a suitable time to examine whether the existing models, structures and processes of consumer participation in health are the ones that will continue to serve us well. The focus of this paper is consumer participation in health policy. It is written to be provocative and raise questions for discussion. Consumer participation in health is a vibrant intellectual area that draws strength and relevance from its largely voluntary participants. However this paper from the 3rd National Health Policy Roundtable argues that more attention and resources need to go into the development of a clearer conceptual and evidence-based framework for consumer participation, if future health policies are to be responsive to and reflective of community needs, and for good policy making to ensue.