Her death from bowel cancer, which had spread throughout her body because, as a public patient, she had to wait over seven months for the simple colonoscopy that would have detected the illness in time, even led to some shuffling embarrassment from the Taoiseach in the Dail.

The day after Ahern's admission that "the system should have allowed Susie Long to be given a diagnosis. . . whether she was a public or a private patient, " a delegation from the Health Services' Action Group, a collection of medical people, former patients and the plain angry who are concerned about healthcare inequity and the need for reform, went to the Dail to meet TDs and senators. Among them was Susie's husband Conor MacLiam, who has pledged to continue her campaign. Oireachtas members from all parties (though not the PDs) were invited. Not a single Fianna Fail TD or senator turned up to hear their suggestions.

Susie Long was the patient who personified the wrong of our two-tier health system; the person who on the grounds of principle (as well as affordability) did not believe in private health insurance; the seriously ill person who had to wait seven months for a simple diagnostic procedure while a private patient in the bed next to her's, suffering from the same illness, got it in three days . . . and is alive today.

Her decision to put her trust in our public health system cost her her life.

On the same day as the Taoiseach was telling the Dail the "system did not live up to its standards" in the way it dealt with Susie Long, Mary Harney was performing another duty as minister for health . . . opening the country's third private VHI Swiftcare clinic.

Harney has said Susie Long's death is "unacceptable too." But in promoting a leading role for private health providers and pursuing her policy of co-locating private hospitals on public hospital land, the minister is once again underpinning even more firmly the two types of care we can expect from our health system . . . the one you get when you can afford it, the one you get when you can't.

It's true the Swiftcare service is for relatively minor accidents and ailments but . . . if you can afford to pay . . . you will be seen within an hour in a beautifully appointed consulting suite, x-rayed, stitched and dispatched in a fraction of the time it takes in the A&E of a public hospital.

As the co-located hospitals are built, expect to see more division, not less.

There is talk that under the consultants' new contract, there will be unified waiting lists for both public and private patients when it comes to diagnosis and treatment in public hospitals.

There have been promises of more and better facilities, of more consultants, of more units for young people with psychiatric problems, of more diagnostic equipment.

The trouble is, as we were told by Brian Cowen last week in his new-look pre-budget outlook report, we are at a different sort of "turning point" to the one envisaged by Susie Long when she hoped her death could be a catalyst for change.

Economic growth will be down to 3.25% next year, a full percentage point below that on which all Fianna Fail's election promises were based.

Unemployment will be up and tax receipts, largely due to the downturn in the construction and housing market, will be down.

It's not a recession . . . far from it. But as Brian Cowen said, perfectly clearly, there will be no room for extras and, if anything, we will see cutbacks in some areas.

That means any talk of extra investment for more consultants, staff and equipment needed to provide a fair health service is just that . . . talk . . . and cannot be realised unless spending is diverted from other areas. A unified waiting list is no good if the public sector does not have the equipment or expertise patients need. And allowing the public sector to "buy" in private health treatment that it cannot provide itself simply further institutionalises the two-tier system by making it increasingly profitable.

We had our chance to reform the health service over the past decade. There have been improvements but the focus was never on the structural reform needed to ensure equity. Because of that Susie Long paid the ultimate price.