The sweetshop window will be piled high with new goodies but the children may still be standing outside with their noses pressed to the glass.
In 10 years, all going well, we are to have the best of primary care - doctors, nurses, physiotherapists, counsellors - available around the clock, around the country.
But despite the new health strategies, despite the impressive plans, this Government has no intention in its remaining lifetime to make the present modest family doctor care available to those who cannot afford it. This outcome will disappoint doctors, patients and even some of the Government's strategists.
This reluctance to dedicate funding where it is most needed must raise questions about the commitment of the Government to implementing its plans for primary care.
The Minister for Health, Mr Martin - doubtless with a significant nudge from the Minister for Finance - has decided to "concentrate on building-up infrastructure in the first instance", he said yesterday in explanation of the Government's decision not to extend eligibility for medical cards in 2002.
Although it had been widely assumed that an extension of eligibility would be announced in the Budget, he stated yesterday "we are not looking at an extension of medical cards limits in 2002." The Government has decided therefore that, apart from the over-70s who now all qualify for medical cards, individuals with an income of over £5,200 a year must continue to pay every time they visit their general practitioner.
A couple with two children must pay once their income exceeds £9,386. The medical card scheme will in effect remain restricted to social welfare recipients and exclude the working poor.
Tom O'Dowd, TCD professor of general practice and a working general practitioner, greeted this news with dismay yesterday. He was at work in the Mary Mercer Health Centre in Jobstown, a model for the Minister's planned primary care one-stop shop.
"Just literally 10 minutes ago I saw a young woman with two children whose income is just above eligibility for a medical card. She said, 'it's going to be great, doctor, with this new health strategy, we are going to get a medical card'. But she won't."
In a recent survey of male patients in their 50s conducted by Prof O'Dowd's practice, 25 per cent of patients reported that either they or a member of their household were putting off going to see the doctor because of the cost. "These would be a very vulnerable group, men with a high cardiac risk factor." Already the payment received by GPs for treating their medical card patients is so low (apart controversially from the newly admitted over-70 year olds) that in areas of Dublin with concentrations of medical card patients and the low paid, there are three times fewer GPs than in middle-class areas, according to Prof O'Dowd.
The Minister for Health explained yesterday that while he accepted the need for increased eligibility "there is a choice here to be made by society: to extend wider eligibility or, what in my view we need, to improve the product first." The health strategy launched on Monday had promised "significant" improvements in income thresholds. The Minister explained that he intended to widen eligibility to include 200,000 more people "commencing in 2003". Achievement of this target would "depend on budgetary matters". Were it achieved, medical cards would cover 38 per cent of the population as opposed to the present 31 per cent.
This deferral is an astounding decision by a Government facing a general election. Over the last year the interests calling for an extension of medical card limits have included GPs, the Society of St Vincent De Paul and the Department of Health's chief medical officer, Dr Jim Kiely.
Dr Kiely's 2000 annual report The Health of Our Children published this summer stated: "Specific policy measures which redistribute resources, provide opportunities and services for families with children, especially poor children, will do most to create better child health. For this reason, basic universal health provision, such as free access to primary care for all children, should be considered."
"Families put off going to the doctor," Mr John Monaghan of the St Vincent de Paul told a seminar last year. "There isn't a conference of the society which isn't paying out money for doctors' bills every day of the week." The society has called for free GP care for children up to the age of 18.
Dr James Reilly, chairman of the Irish Medical Organisation's GP committee, has supported a trebling of the income threshold for medical cards.
The two major opposition parties support extending free GP care in an insurance-funded health care system. The Labour Party has proposed free GP care for all. Fine Gael has proposed free GP services for the under-18s, students, the over-65s and the lower 60 per cent of income groups.
An earlier draft of the Government's primary care strategy, prepared by an informal working group, and seen by The Irish Times, had argued for free access to the primary care teams.
"Acute hospitals services are universally eligible whereas primary care services are not. Ideally there would be universal eligibility to these teams. . .
"Many people not entitled to medical cards do not attend for services from which they could benefit particularly in the area of prevention such as hypertension, asthma and diabetes," the draft stated.
Referring to concerns about the cost of free access, the draft suggested "one possibility to offset the cost would be a system of insurance for primary health care." Such a system would require by law that all people should take out insurance for primary healthcare with the State reimbursing premiums to those on low incomes, it continued.
The authors of this draft would find greater common ground on this issue with the opposition than the Government.