State-led innovation and its limits: The rise and fall of Medresco hearing aids in postwar Britain (1943–1982)

We analyze the development and distribution of hearing aids in the UK from 1948 to 1982, when the state produced and distributed the Medresco device. Using a historical study of the Medresco program, we show that direct state involvement initially expanded access to hearing aids by defining it as a social right and coordinating an expert-led public innovation system. Yet, the program’s decline exposes a governance problem in the state-led innovation process. During the shift to transistor technology, expert authority weakened under administrative and political pressures even as user preferences shifted toward smaller, less visible devices. As stigma and aesthetics became central to acceptability, Medresco’s standardized design lost legitimacy and even became stigmatized despite clinical adequacy. The case suggests that sustaining welfare technologies requires institutional capacity for continuous redesign and that design and stigma dynamics can redefine what counts as adequate, reshape competitive dynamics, and ultimately transform provision.