Despite widespread calls for greater public involvement in governance, especially in relation to health policy, significant challenges remain in identifying any such legitimate ‘public’ voice. This research investigates this problem through a case study. It examines how actors experienced and interpreted a government-commissioned citizen’s jury on health spending prioritization in relation to the work of the local health care consumers’ organization. The analysis highlights an unproductive tension around this encounter, and points to more complementary ways in which such top–down and bottom–up efforts might be coordinated. It, therefore, contributes significantly to efforts to strengthen the public voice in contemporary health governance.