The British Toilet Association www.britloos.co.uk is very concerned to learn from OTS news.co.uk of the threat to the public toilets in Maghull. The problem is that providing public toilets is not a statutory requirement in spite of the fact that we all need the loo.
Committee Member Gillian Kemp totally agrees with the statement in the article that suggests that people can become prisoners in their own homes – this of course can have the knock on effect of adding to NHS costs.
Below is the text of a poster that was presented to the Faculty of Public Health last year which outlines the effects of public toilet closures.
Supporter, The IBS Network <www.theibsnetwork.org>
CLOSING PUBLIC TOILETS: Is this the healthy way forward?
Gillian Kemp MA, Hatfield, Hertfordshire: Management Committee Member, The British Toilet Association
1 Introduction 2 Reasons cited for toilet closures 3 The Lack of Public Toilets 4 Who is affected by Toilet Closures? 5 Facts 6 Impact on Health 7 Impact on health costs 8 Advantages of Public Toilets 9 Local Authorities 10 Guidance 11 Toilet Pro-Vision for 21st Century 12 Conclusion 13 References 14 Useful Reports 15 Useful Books
1 Introduction When public toilets close down there are many health issues that can arise which affect a large proportion of the population. If we are to embrace the Government’s idea of an all-inclusive Big Society, public toilets are a necessary requirement for our future health • In the Nineteenth Century: public toilets were introduced and the UK had the best toilets in the world • In the Twentieth Century: public toilets could be found in a wide variety of locations – parks, seaside, towns, cities; some with child friendly facilities • In the Twenty-first Century: 40% of public toilets are now closed and the UK is no longer has the best toilet provision although there are regional variations. Communities and transport systems are being built without toilet facilities. Why is this happening and what is the impact?
2 Reasons cited for toilet closures • Vandalism • Drug Abuse • Inappropriate behaviour • Maintenance costs • Disability Discrimination Act [now mostly replaced by the Equality Act 2010]
3a The Lack of Public Toilets  • Ignores a basic human requirement • Affects quality of life eg social isolation • Incurs additional costs: medical + social services & national and local authorities • Encourages unhygienic practices • Are often gender discriminatory • Affects the local economy
3b The Lack of Public Toilets ….. • Reduces opportunities for physical activity • Reduces independence • Can contribute to mental health problems • Can result in infections • Leads to embarrassing, distressing & undignified incidents • Encourages urban / rural fouling = effect on environment
4a Who is affected by Toilet Closures ? • Older people: eg ability to ‘hold on’ decreases • Men: eg prostate issues • Women: eg Pregnancy, birth, menstruation, menopause; often main carer; out & about more  • Children: eg toilet training; urgency • Young people: eg with bowel/bladder problems 
4b Who is affected by toilet closures ? • Those on certain medication • Those with visible & invisible disabilities • Visitors & tourists • Night time tourists particularly women • Mobile workers • Volunteers • Night time workers • Homeless people
5 Facts • Around 14 m people in the UK suffer with urinary problems, symptoms & incontinence  • Around 7 m of those suffer with bowel problems • Around 1.2 m older people feel trapped in their own home 
6 Impact on Health • Effect of reducing/stopping fluid intake • Reducing medication to avoid the loo • Effect on children’s developing bladders / bowels • Loss of ability to be active = other health issues • Possible stroke/ heart attack  • Problems related to lack of hygienic surroundings eg for long term conditions
7 Impact on health costs • Cost of products eg incontinence pads to NHS • Cost of treating infections • Cost of treating mental health problems • Costs of staff having to clear up fouled areas – their health care • Cost implications re: carers
8a Advantages of Public Toilets • Contribution to sustainability of communities • A vital link enabling public transport usage • Opportunity to participate in community life • Supports 24 hour economy
8b Advantages of Public Toilets to Business • Higher retail turnover  • Increase in visitors to tourist attractions • Encouraging stay & spend • Enable potential / employees to take up work opportunities
8c Advantages of Public Toilets to Health [a] • Reduce ‘holding on’ which can cause health problems ,  • Reduce infections including tampon infection  • Reduce medication worries • Allow more freedom to go out and about
8d Advantages of Public Toilets to Health [b] • Provide a place to cope with biological needs, eg baby changing, menstruation • Sanitary space to cope with medical needs • Encourage good hygienic practices • Encourage people to go out and about • Reduce incidents of fouling
9a Local Authorities  • No special funding for toilet provision • Those responsible for toilet provision often have little involvement in planning policy • No recognised structure in which public toilets are included • Consultation processes often inadequate • No suitable alternative to closures offered
9b Local Authorities  • Considerations • Toilet strategy? • Charging for use? • Advertising opportunities? • Community toilets as additional facilities? • Signage! • Useful opening times • Reputation determined by state / lack of toilets! • Loo of the Year Award
10 Guidance • British Standard BS 6465-4: Code of Practice for the provision of Public Toilets.  • Advice from the British Toilet Association [BTA] <www.britloos.co.uk> • Loo of the Year Awards: Encourages highest possible standards in ‘away from home’ toilets <www.loo.co.uk> • ‘Publicly Available Toilets: Problem Reduction Guide’ [BTA + Hertfordshire Constabulary] • Changing Places Consortium <www.changing-places.org>
11 Toilet Pro-Vision for 21st Century • Legislation or Responsibility? • Strategic guidance • Involvement of Environmental Health professionals • Involvement at national and local levels • Areas of new / regeneration building • Town centres: enabling access to services • Road routes: making travelling easier • Additional use of public buildings • 24 hour access • Good up to date signage • Toilets for All: An Inclusive Society
12 Conclusion: • We need to talk about TOILETS! • Public Health impact often hidden because of embarrassment • Closing public toilets impacts on health & lifestyle • Campaigners around the UK demonstrate the value placed on public toilets • Public toilet provision should be the norm – not an afterthought • Strategy required – a strong framework • Many local authorities provide high standard toilet facilities despite the current economic climate • MORE public toilets provision required, not less! • Closing public toilets is NOT the healthy way forward
13 References 1 ENCAMS [now Keep Britain Tidy]: omnibus questionnaire, June 2006 2 Bladder & Bowel Foundation: Populus Research interviewed 1040 adults aged 18+ years, 19-22 June 2008. 8% under 24 years reported a bladder &/or bowel control problem 3 National Assembly for Wales, March 2012: Public health implications of inadequate public toilet facilities – report of evidence 4 National Assembly for Wales, March 2012: Public health implications of inadequate public toilet facilities – report of evidence 5 Help the Aged [now Age UK], 2007: Nowhere to Go: Public toilet provision in the UK 6 National Assembly for Wales, March 2012: Public health implications of inadequate public toilet facilities – report of evidence 7 The Association of Town Centre Managers, Survey 2001 8 Edwards J, 1998a ‘Local Authority Performance Indicators: Dousing the Fire of Campaigning Consumers.’ in ‘Local Government Studies 24 (4): pp 26-45 [Clara Greed ‘The Role of the Public Toilet in Civic Life’ in ‘Ladies & Gents’ ed Olga Gershenson & Barbara Penner, Temple University Press, 2009] 9 Barzhoff, John. 1990 ‘Final Frontier for the Law?’ National Law Journal, April 18 [Kathryn H Anthony & Meghan Dufresne, ‘Potty Privileging in Perspective’ in ‘Ladies & Gents’ ed Olga Gershenson & Barbara Penner, Temple University Press, 2009] 10 Armstrong, L & A Scott. 1992 ‘Whitewash: Exposing the Health and Environmental Dangers of Women’s Sanitary Products and Disposable Diapers’ Toronto: HarperCollins [Clara Greed ‘The Role of the Public Toilet in Civic Life’ in ‘Ladies & Gents’ ed Olga Gershenson & Barbara Penner, Temple University Press, 2009]
14 Useful Reports National Assembly for Wales, March 2012: Public health implications of inadequate public toilet facilities – report of evidence London Assembly, Health and Public Services Committee, July 2011: Public toilets in London, Update Report Communities & Local Government, March 2008: Improving Public Access to Better Quality Toilets, A Strategic Guide House of Commons: Communities & Local Government, Twelfth Report of Session 2007-08: The Provision of Public Toilets Help the Aged [now Age UK], 2007: Nowhere to Go: Public toilet provision in the UK
15 Useful Books: At Women’s Convenience: A Handbook on the Design of Women’s Public Toilets, Sue Cavanagh & Vron Ware, Women’s Design Service, 1990 Inclusive Urban Design: Public Toilets, Clara Greed, Architectural Press, 2003 Ladies and Gents, ed Olga Gershenson and Barbara Penner, Temple University Press, 2009