From its inception, the NHS was a focus for medical research and invention, as well as the delivery of established medical treatments. The constant need to cut or contain costs while providing state-of-the-art services to all was one key driver of innovation. Cost certainly played a role in Ministry of Health’s decision to commission a brand new hearing aid for the NHS in 1948. The Medresco hearing aid – its name derived from the UK Medical Research Council through which its development was funded – was the result.
As early as 1944, the wartime government had expressed a keen interest in the development of affordable ‘national standardized hearing aids’, not least to facilitate their free provision to soldiers whose hearing had been damaged in military service. While the MRC investigated the electro-acoustics of hearing replacement, the government opened discussions with the Association of Hearing Aid Manufacturers.
In the end, these discussions were unsuccessful. Private manufacturers, intent on creating ever-smaller devices for paying customers, did not or could not offer an economical solution for the masses. When the advent of the NHS opened the door to universal provision, its leaders chose to go it alone. The resulting Medresco device was (at least in the eyes of its supporters) a symbol of the new, egalitarian Britain of the post-war years, and of the NHS which would make ‘positive health’ accessible to all. Nor was the Medresco machine to remain static: by 1951, three improved models had already emerged, and the device was regularly updated.
Like spectacles and dentures, Medresco hearing aids were available for free through the NHS, and uptake was substantial. Given the initially limited scale of manufacture, long waiting list were inevitable, and largely accepted with patience. While the NHS was issuing the aids at a rate of 1,015 per week by the end of 1949, 86,000 patients were still waiting. A survey found that half of users were ‘enthusiastic’ about the aid, while 83% approved of it. For most, the cost of a commercial aid would have posed ‘real hardship’: the aid, researchers concluded, had already made ‘a very real contribution to the welfare and happiness of deaf people in this country’. 320,000 had been issued by 1953. For children and the ‘aged deaf’, Medresco devices were a ‘blessing’.
Yet almost immediately, some specialist medical professionals and the makers of proprietary devices began to complain about clinical ‘totalitarianism’: only the Medresco devices could be demonstrated in NHS clinics, and only they was free. In 1953, a new survey of use reported that some Medresco devices barely made it out of their boxes, and only 18% were ever used in the workplace (though researchers were swift to point out that this was mainly because most users – children and the elderly — were not in employment). The Hearing Aid Manufacturers Association immediately asked why NHS users should not have the benefit of developments in the commercial hearing aid sector? ‘The exclusion of commercial hearing aids from the Health Service means that the hard-of-hearing are denied new developments as they become available’, manufacturers complained. Perhaps instead of giving its ‘national’ hearing aid away for free, the nation would get better value for money by spending more on earlier diagnosis and prevention of deafness (and implicitly, leaving those diagnosed to buy the hearing aids of their choice).
By 1959, some doctors condemned the Medresco aid as ‘archaic and conspicuous’. In contrast, defenders observed that the now decade-old device, while ‘obviously cumbersome by modern standards’, ‘remained robust’ and in terms of performance, still compared ‘favourably’ to ‘expensive commercial instruments’. A user noted that while ‘cumbrous’, the Medresco aid was durable – and besides, surely instead of complaining about the hearing-aid’s bulk and visibility, ‘it is time and more that the general attitude towards deafness and hearing aids changed until they are taken for granted like short-sight and spectacles. Deafness is a disability, not a misdemeanour.’
The Medresco aid began its life as a symbol of medical modernity, inclusiveness and egalitarianism. But it was never uncontroversial, and was not always loved by users embarrassed by the stigma of disability, or the popular association between hearing loss and old age. In 1973, the profession called for a new report, and production and prescribing of the device had been discontinued by 1982 in favour of ‘more modern’– and commercially made – devices.