The 30th anniversary of the United Nations Convention on the Rights of the Child has provided opportunities for reflection, critical analysis and renewed commitment. While the convention is comprehensive and far reaching, the focus here is specifically on the rights of children in health care, with particular emphasis on the Australian setting. Surveys and related studies have highlighted persistent gaps and inadequacies in these domains of practice and especially in the direct and meaningful engagement of children and young people. The implementation of article 12 of the convention, the right of children to be heard and taken seriously, has been identified as a distinctly confronting challenge and the subject of improvement initiatives across, as well as beyond, health services. Appropriate reforms can only be progressed and sustained within a broader policy context that places children first and foremost, values their participatory engagement and embraces the crucial contribution of children's health and wellbeing to the future of our society.