Charitable payment to the sick reduced to small coin (10)
I believe the answer is:
beneficent
'charitable' is the definition.
(similar in meaning)
'sick reduced to small coin' is the wordplay.
'sick' becomes 'benefic' (I am not sure about this - if you are sure you should believe this answer much more).
'reduced' means to remove the first letter.
'to small coin' becomes 'cent' (eg a US cent).
'cent' with its first letter removed is 'ent'.
'benefic'+'ent'='BENEFICENT'
'payment to the' acts as a link.
This may not be right. Some or all of it may belong to another bit of the clue.
Can you help me to learn more?
(Other definitions for beneficent that I've seen before include "Generous" , "Doing good" .)