The importance of socioeconomic conditions for health status has long since been recognised internationally, and there is general agreement that maximising health production requires action on all social, economic and environmental factors potentially influencing health status. In Ireland too, the multifaceted nature of health production has been acknowledged, but this has not led to real policy change in respect of prioritisation and consequent resource allocation. The emphasis in Ireland remains narrowly focused on access to acute health care services as the core strategy for equalising health opportunities across the population. While equal access for equal need is an essential component in ensuring better, and more equal, health outcomes, particularly in relation to accessing new technologies, it is insufficient in its own right to deal with many of the economic and social determinants associated with health production. This paper argues for a comprehensive health reform programme to encompass the many determinants of population health; such an approach would provide the opportunity for all citizens to maximise their health potential.