By Anna-Marie Lever
BBC News health reporter
According to Card Aid the average person buys 30 Christmas cards at this time of year. If these are what the charity calls 'real charity cards' they can make a difference.
"Thirty cards could restore the sight of a child born with cataracts," says Dame Hilary Blume, director of the Charities Advisory Trust, of which Card Aid is an initiative.
"The problem is that some main high street shops are making a sham out of the charity Christmas card.
"This year, more than ever, they are offering discounts - you can buy charity cards for as little as 5p, which means that less than half a penny a card goes to charity."
As well as calling for a sensible premium to send a charity card, the Charities Advisory Trust is campaigning for legislation to ensure that a card can only be given the charity label if more than 10% of the price actually goes to charity.
"Currently, if the sale of a card gives as little as a farthing to charity it can call itself a charity card," said Dame Hilary.
Card Aid, a not for profit organisation, gives the charity 40%-60% of the sale of the card to charity.
Another way to ensure you are buying a 'real charity card' is to go directly to the charity.
The Snowman
Every year the Great Ormond Street Hospital (GOSH) shop sells their own charity cards.
"All the proceeds of our charity cards come back to the hospital," said Hannah Sturrock, from the Great Ormond Street Hospital Children's Charity.
"We manage to keep the costs down on the production of the cards through a good relationship with our publishers and printing the cards en masse.
"I didn't think it would become a best seller"
"All the proceeds from the cards go directly to the charity and fund pioneering research, life-saving equipment, accommodation for parents and the rebuild and refurbishment of the hospital."
Included in this year's card selection is a smiley Snowman card designed by 10 year old patient Milly.
"I didn't think it would become a best seller," she giggles, "my mum has brought millions of them ... tonnes of them."
Best Sellers
Thomas Bates, manager at The Almanac Gallery, a Christmas charity card publisher explains: "Patient designed cards will always sell a certain amount because some supporters will appreciate the deeper and direct connection to the charity.
"However, when the design works well in its own right then it will become a best seller as it offers double value, and will be bought by some on design value alone."
Another successful patient designed Christmas card is Sylvia Smith's 'Oh Come All ye Faithful' for the Stroke Association.
Sylvia had a stroke two years ago which resulted in left-side paralysis. She has regained the ability to paint despite the fact she is left-handed.
Mr Bates explains how he works alongside charities to keep printing costs down and allow for maximum proceeds.
"One way is for the charity to buy cards from us wholesale and then sell their cards through mail order, website, their own shops or temporary charity Christmas card outlets.
"Typically a charity will be able to sell a pack of cards at a 60%-70% margin.
"Sales through the web are increasing and obviously offer the lowest cost."
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