The opening of public toilets carries with it a risk of transmission of COVID-19 given the low levels of natural light, lack of ventilation, many surfaces to touch and the purpose of a toilet. Therefore, there is a need for careful consideration of how public toilets can be opened as safely as possible.  

Safe opening will vary according to specific sectors and should align to the guidance provided by those sectors in terms of restart. Assurance that adequate sanitary facilities can be provided where appropriate is integral to the restart process.

Public toilets are defined as any toilets accessible to the public. The opening of toilets should be accompanied by local risk assessment, and control measures should be proactively monitored by operators. Most premises should have a norovirus policy that can be adapted for use in cleaning facilities if an individual with COVID-19 symptoms is known to have used the facilities.

Risk assessment should specifically include:

• remote/unmonitored facilities for which there may be increased demand as travel restrictions are eased and people start travelling greater distances
• janitorial staff for whom operators should already have procedures/PPE in place
  
  

Any modifications or changes must take existing regulations into account. Regulations on the provision of public toilets are governed by a number of British Standards developed by the British Standards Institution (BSI). The key standards which apply to the provision of public toilets are BS 6465 parts 1-4 and BS 8300 for accessible units

In opening toilets, operators should:

Prior to opening:

• conduct routine checks and take all measures appropriate to reopening after a prolonged closure e.g. consideration of requirements for legionella risk management due to stagnant water in plumbing systems
• adjustments must be made such as signage, taping off areas and floor markings to ensure physical distancing and facilitate good hand and other hygiene
• review all toilet and sanitary facilities (including disabled and baby change areas) to determine whether the fixtures and fittings are in good working order and replace or repair if not
• consider the need for additional waste management arrangements

Enhanced cleaning

It should not be assumed that hygiene measures in place pre-COVID-19 will be sufficient.  Enhanced cleaning is likely to be required and should take into account:

• frequency – should be increased beyond what has been the case before COVID-19 and should be based on a risk assessment which includes both the usage of the facility and the fact that COVID-19 survives on the hard surfaces present in toilets for at least 72 hours
• products used – should be a disinfectant not detergent-based product  
• areas of particular concern – it is important that attention is paid to frequently touched areas including toilet flush, toilet seat, toilet locks and handles, taps, paper towel and soap dispensers and door handles on access/entry
• enhanced monitoring of facilities will be required to ensure hygiene is maintained
• clearly display enhanced cleaning rota and ensure it is adhered to i.e. a documented record that the checks have been carried out for the public to see
• the cleaning rota should be supplemented with a cleaning schedule or similar procedure log that details the manner and frequency of cleaning of the various surfaces
• remove any unnecessary or communal items within the facility (e.g. ornaments or cosmetic items) to facilitate cleaning
• ensure that if a staff key fob or key is required to access the facilities this is cleaned between uses
• PPE should be provided in line with Health Protection Scotland Guidance for  General (Non-Healthcare) Settings
• staff should be trained in appropriate cleaning methods for sanitary areas and the use of the equipment and products for cleaning and disinfection
• special care should be taken with the cleaning of portable toilets

Equipment

• reusable equipment should be removed and replaced with disposable (e.g. fabric towels, baby-changing mats)
• ensure that there are adequate hands-free waste disposal units
• cleaning materials for surfaces should be provided (e.g. antibacterial wipes for baby change areas)

Communication

• use signs and posters to: build awareness of good handwashing technique and reinforce the need to increase handwashing frequency, to avoid touching your face; and to cough or sneeze into a tissue, which is binned safely, or into your arm if a tissue is not available
• consider providing a contact number for the public to use should they have any concerns regarding cleanliness (e.g. if the facility has been heavily soiled between cleans). Use signage to tell the public what to do if someone falls ill with suspected COVID within a toilet facility
• COVID-19 can present with diarrhoea and or vomiting therefore it is important to have a mechanism to ensure the facility can be closed and adhoc cleaning can be arranged should the need arise

Hand hygiene

• provide liquid soap and ensure there is adequate stock at all times
• consider providing hand sanitiser dispensing units in portable toilets where handwashing can be less effective
• consider adjusting the time that push/sensor taps are on to encourage 20 seconds of hand washing
• provide hand-drying facilities – either paper towels with appropriate and frequent waste disposal or electric hand driers
• reduce the requirement for surfaces to be touched once hands have been washed on the way out of facilities e.g. prop open exit door
• consider providing hand sanitiser gel at the entry and exit from the facility. With adequate hand washing, the contamination of contact surfaces on leaving the facilities should be minimised. However, we know that many people do not wash their hands properly

Physical distancing

• operators should consider how to limit the number of people within facilities with multiple stalls/urinals e.g. with signage on the door instructing users to wait outside if they find that the facilities are occupied
• physical distancing should be maintained by way of signage and floor markings and, in respect of staffed toilets, proactively encouraged by staff
• consider whether additional measures such as physical barriers are required e.g. cubicles provide barriers but wash basins and urinals (trough urinals, in particular) will require greater consideration
• consider whether distances between equipment e.g. hand basins are sufficient and consistent with physical distancing policy
• consider the route to and from toilets, in particular how to maintain physical distancing and cleaning of possible touchpoints
• use one-way systems where this is possible

Sanitary facilities provision

• where toilets are being provided for a specific event, consider whether the standard guidance on toilet to person ratios needs to be revised to allow for physical distancing and enhanced cleaning routines
• note that more toilet facilities may be needed for the same number of people due to the physical distancing and hygiene measures
• note that there may be a greater number of people who need to use public toilets than usual as behaviours are influenced by current guidance (e.g. more people meeting in parks)

Following opening, there should be regular and proactive inspection of facilities to detect and address any issues promptly.  

World Toilet Day:
HGV drivers deprived of human right to sanitation

12:00 Tue 19th Nov 2019 | Posted By UKHAULIER EDITOR

Many of the UK’s HGV drivers are deprived of the United Nations (UN) Human Right to sanitation due to the lack of toilet facilities on the national road network, according to FTA, the voice of the UK logistics sector. Speaking on the UN’s World Toilet Day (19 November 2019), FTA is renewing its calls for government to prioritise the provision of sufficient welfare facilities for professional drivers across the UK.

Elizabeth de Jong, Director of UK Policy at FTA, comments: “The logistics sector is the lifeblood of the UK economy, ensuring businesses, schools and hospitals are all stocked with the goods they need to operate. But despite the invaluable contribution HGV drivers provide to the economy, they are often denied access to very basic amenities. The inconsistent provision of toilets and other facilities for HGV drivers across the road network is not good enough; access to hygiene amenities and other welfare services are a basic right for all workers. No other industry would be expected to work without access to toilets, so why should HGV drivers?

“More than 18 months ago, the government vowed to improve and expand the provision of facilities for those charged with keeping Britain trading, but since that promise, amenities have actually become worse. Nearly all the respondents to a survey conducted by FTA of its member organisations felt there had been no improvement in the facilities for drivers on local roads, and over half of them felt that the provision had become worse over the last 12 months. In an industry where you are compelled by law to take regular breaks and rest, it is vital drivers have access to these most basic facilities.”

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The – Problems – with – modern – day – Toilets

 Medical studies have suggested that it can cause swollen haemorrhoids and
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 In modern times , the workplace toilet has become private texting and social
media usage space.
 In commercial shopping malls and train stations, a requirement to reduce queuing
has become a necessity.
Innovation – Product Design
Health & Wellbeing
Medical studies have suggested that using the traditional WC can cause swollen
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* NHS- UK Guidance Notes *Harvard Medical School

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   8.   Easy sit on / get up design
   9.   Health Benefits – Reduction in haemorrhoids/musculoskeletal disorder

Reduce queuing

Current toilet seats provide a horizontal seating surface. This enables a user to sit
relatively comfortably on the toilet. As a result, a user may spend longer than
necessary sitting on the toilet without short-term discomfort. Sitting on a toilet for
longer than is necessary is generally undesirable.

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Specification

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2.   Soft Close toilet seat option
3.   Water saving 3/6 Litre Dual Flush
4.   Available in White/Grey
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6.   Specially designed slots in the rim allow for a more uniform, quieter flush
7.   Ceramic is high-pressure cast, yielding a more uniform and consistent product
8.   Easy sit on / get up design
9.   Health Benefits – Reduction in haemorrhoids/musculo-skeletal disorder

Benefits to Disabled Toilet users: By using our uniquely designed WC, the time spent on the WC is considerably reduced, easing queuing congestion and benefitting by reduction in overspill usage
of disabled facilities.

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 Swindell & Pearsons file No: RPL/SP/44435GB
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Business case Details and
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REPORT ON THE SERIOUS DECLINE OF PUBLIC TOILETS

1: Introduction

1.1 Unhealthy, uncivilised and unfair: public toilets through the ages Provision of toilets outside the home dates back to ancient times, although the modern history of these facilities is from the late 19th century. Old-style toilets, often termed ‘nuisances’, drained directly into rivers or streets: these were removed from UK cities from the mid-19th century onwards. The problem for an increasingly mobile population was that such facilities, however unsatisfactory, were not usually replaced. The emphasis was on cleaning up the environment and there was little or no concern for the working classes lacking access to toilets. There was also an assumption that, with homes increasingly having toilets (albeit often outside or shared in poor communities), there would be natural progress in sanitation. The Great Exhibition of 1851 presented the public with flushable water closets that proved both popular and profitable, but a trial of the economic feasibility of public toilets by the Royal Society in 1852 made a large loss.

Nevertheless, the idea that public toilets could and should be profitable has persisted, associated with an implied assumption that these are optional luxuries, with no legislation requiring public toilets on the UK statute books. In a study of the heyday of public toilets at the turn of the last century, the most prominent block to provision was funding, as it is now.1 In the latter half of the 19th century a few public places, such as railway stations, installed toilets; but there were still no street facilities for women, and provision in workplaces was inconsistent – again with usually none for women. Prompted by lack of facilities and concerns about street urination, the 1880s onwards saw installation of public toilets in most UK cities, often with grand architectural design, celebrating the newly established improvements in plumbing and sewerage. Legislation was introduced for required provision in workplaces and schools, but not elsewhere.

Figure 1 – A former public toilet in Spitalfields, London, converted into a wine bar and put up for sale again in 2016 for £1 million. 

During the first half of the 20th century, public toilets continued to increase in number, funded usually by local authorities (LAs). Some were free to use, but many required payment. The charge was one old penny until decimalisation of the currency in 1971, but usually there was a free cubicle for those without a penny to hand or to spare, a feature which has since disappeared.
In more recent decades the increasing pressure on LA budgets has led to the privatisation or closure of many public toilets. Sub-contracted or privately operated toilets make a charge, usually 50p or more. They tend to be located in highly frequented areas such as tourist spots and in general they have restricted opening hours. Legislation from the 1960’s banning turnstiles – on the basis that they are unfair to the disabled, as well as to those without money – has since been repealed to allow ‘pay to enter’ facilities. Where public toilets cannot be privatised, many have been sold off for other purposes or simply closed (Figure 1). Introduction of legislation to improve disabled access has had the unfortunate consequence in some cases of several public conveniences being replaced by just one disabled access toilet. On top of this, many of the required accessible toilets are not fit for purpose or are inconveniently located. Sporting venues are also poorly served, with particular problems for the disabled.

1.2 The present day:

Deserts of Inconvenience? According to a BBC report in 2016,3 local council cuts caused one in seven public toilets to be closed between 2010-13, the UK situation being described as “deserts of inconvenience” from “Wandsworth to Newcastle”. The report identified ten areas in England and Wales with no council-run public toilets at all. In a further BBC report in 2018,5 this loo absence had increased to 37 areas of the UK. This should come as no surprise given four out of five councils cut spending on public toilets between 2011 and 2016,3 a trend that shows no sign of reversing. While the few public toilets available do tend to be found more frequently in tourist areas, the shortage of ‘places to go’ for large groups has become a major concern for tourism, now a major income generator for the UK. Workers ‘on the move’, such as tourist guides, drivers of lorries or buses and postal workers, have often complained in vain of the lack of facilities.

Equality of access to toilets is an important factor, particularly for women who take longer and cannot use urinals. This leads to the long queues familiar in many public toilets (Figure 2). In a YouGov UK survey in 2017, 59% of women reported that they regularly queue for a toilet, compared with 11% of the men.7 Because of time consuming factors related to clothing, menstruation, and anatomical differences, a fair ratio of toilet provision would be at least 2:1 in favour of women. Calls to address this unfairness have led to ‘potty parity’ legislation in some US states and Canada,8 although not yet in the UK, where the British standard is still 1:1, despite a recommendation from the British Toilet Association for at least as many female cubicles as there are cubicles and urinals in male toilets.9 Equality of access includes the demands for ‘gender neutral’ toilets and the needs of transgender individuals.10
Local council cuts caused one in seven public toilets to be closed between 2010-13

In an age when previously shocking topics are readily discussed and aired in the media, there persists a reticence about either discussing public toilets or acknowledging the increasing problem of their absence. The most recent House of Commons public inquiry into toilets in 2008 referred to the taboo still surrounding the subject11 and this is further demonstrated by various euphemisms for these facilities, such as cloakrooms, rest rooms or conveniences. Low priority is given to planning and ensuring appropriate provision, and it is a great shame that the issue has been side-lined in this way. In fact, failure to provide public toilets has implications not just for sanitation and general convenience, but also for levels of social isolation and physical activity among certain groups, through restricting their ability to go outdoors.
UK public inquiries in this century have lamented the decline in public toilets,11,12 while coming up with few practical solutions, save for community toilet schemes, whereby local cafes and other establishments receive modest funding to allow people to use their toilets without having to buy anything. Such schemes are suitable mainly for individuals: while they undoubtedly add to the provision of facilities, they do not address the needs of groups, many of the disabled or most of the homeless.
Figure 2 – Women queuing at the Embankment public toilets, London These toilets were first erected in 1911 with the aim of reducing “nuisances committed in doorways and the public street”. There is now a charge for entry. Note no queue for the ‘Gents’ on the left side. Photo: R. Stanwell-Smith
[BBC, 2018] In 2010 there were 5,159 toilets run by major councils in the   to 4,486 in 2018

1.3 Missed opportunities

While there have been some hard won improvements to policy and British Standards on toilets,13,14,15 Wales is the only part of the UK with a new Public Health Act requiring local authorities to publish a local toilets strategy for its area. The ‘Inconvenience Committee’ of professional tourist guides successfully campaigned for the large Unite Union to pass a demand for statutory provision of public toilets a decade ago, although this has yet to be acted upon.
A recommendation that all the new Crossrail stations in London should have accessible toilets has not yet been fulfilled, with the admission that some key points, such as the busy Bond Street station, will have no toilet facilities whatsoever.  While in 2017 the Mayor of London announced that in the draft London plan, more public toilets will be provided for London’s diverse population,17 there has been no recent update on progress. The recent good news that some London stations will allow free access to the toilets within station precincts is welcome – but as yet there is no indication this will apply in all stations.

The international perspective on toilets focuses on the World Health Organisation’s goal of universal basic sanitation by 2030, and we must not forget that with most UK homes having at least one toilet, we are better off than many parts of the world. World Toilet Day (November 19th) is now a regular reminder of the 2.3 million people who lack access to a clean and safe toilet, an improvement on the 2.6 billion in this plight in 2010 but slow progress nonetheless. While the international priority therefore is directed to ensuring toilets within the home, in many regions people will only have access to public toilets in the foreseeable future, or no toilets at all. Even when most homes in the world have a toilet, there will still be a need for public facilities, just as there is in the UK.
Provision of toilets has been called “the barometer of civilisation” and the UK should continue to support the international efforts required – but also must address the current state of neglect for public toilets we see in this country today.

The Global Picture

2: The health impact of declining public toilets

2.1 Loo leash
Most of us need a public toilet occasionally, but this is a more urgent problem for those with medications or medical conditions causing increased frequency of the need for a toilet (such as diabetes, or bladder, bowel or prostate conditions). In addition to diagnosed conditions, advancing age increases the need, as does the requirement for nappy changing and young children who can’t wait. Knowledge of the lack of facilities nearby acts as a ‘loo leash’, deterring some from venturing far beyond their homes. It is deeply concerning that at a time when public health policy is to encourage outdoor exercise, partly to reduce obesity and also to keep our increasingly elderly population fit and engaged with the community, our declining public toilet provision is in fact encouraging more people to stay indoors.
2.2 ‘Holding it in’
Deliberate dehydration or ‘holding it in’ to reduce the need for a toilet is commonly practised by those who fear not being able to find a public loo, but this can seriously affect health and exacerbate existing medical problems such as cystitis (Figure 3). Water bottle refilling points have been installed in several places in the UK, but public toilets would provide an ideal location, with the advantage of frequent water flow to prevent stagnation and possible contamination, a problem that has rendered many old-style drinking fountains impossible to maintain hygienically.
2.3 Sanitation
The health impact of public toilet closures includes the problems of street urination and defecation. Bye-laws prohibiting public urination do not exist for over half the LA’s in the UK, and where they do they are rarely enforced. It is difficult to estimate the hygiene impact of this but it is insanitary to have contact with faeces or urine, the contamination not always being clearly visible. This is a particular risk to young children and wheelchair users. Add to this the lack of hand washing points, for people eating out of doors or when travelling, and you have the potential for contamination by pathogens causing individual illness or contributing to epidemics. In poor areas in the US, emergency installation of public toilets and washing facilities has been used to control outbreaks of dysentery and hepatitis, such as on Skid Row in Los Angeles.

Figure 3 – Health effects of deliberate dehydration

Health effects of deliberate dehydration
Weakness, dizziness, reduced physical performance, reduced short-term memory and other cognitive performance, depressed mood, less alert
constipation, cystitis, increased risk of renal stones and headache

3: The public’s views
In September 2018 a questionnaire survey was conducted for RSPH on what the public think about the decline in toilets, as well as ideas for how toilets could be funded, health implications, and access implications for women. Conducted by Populus, the survey included 2,089 UK adults aged 18 or over, with a standardised data base to represent factors such as income, gender, age and region.

3.1 Lack of provision
Given the rate of closures, it is unsurprising that 74% of people reported that there are not enough public toilets, with an increasing proportion by age
(Figure 4). There was some overall regional variation, with a range of 65% (E Midlands) to 82% in Wales and NW England. For those who need a toilet frequently due to illness or other condition (19% in this survey), the percentage reporting not enough public toilets was 85%. Regarding location of toilets, over 60% reported that there are insufficient public toilets in parks, although this figure was above 30% for other places, such as tourist areas and shopping centres (Figure 5). The majority of women and men in the survey (84% and 69% respectively) agreed there should be greater provision of toilets for women, although only 25% of the women and 30% of the men thought that toilets should be unisex to reduce queues. For the latter question there was an inverse relationship with age, with 38% of younger people (18-24 years) favouring the unisex toilet option, compared with 26% of those aged 65 years or more.

• Three in four (74%) of the public say that there are not enough toilets in their area
• One in five (20%) don’t feel able to go out as often as they like
• More than half of us (56%) restrict our fluid intake before going out to reduce the need to find a toilet

Not enough public toilets?

% by age group 100 80 60 40 20 0 18-24yrs 35-34yrs 35-44yrs 45-54yrs 55-64yrs 65yrs

Figure 4 – Percentage of responders by age who stated there are not enough public toilets

3.2: Places of convenience
When people in the survey could not find a public toilet, supermarkets were a popular option (70%), followed by cafés or restaurants (63%). A smaller proportion resorted to pubs, petrol stations and betting shops, but of greater concern was the 16% who use a back alley or bush, this percentage being higher for men and for those with a frequent need for a toilet (Figure 6). Seventy-one percent of women reported that they never did this, compared with 41% of the men. Nearly a third of all areas combined (29%) reported that street urination was a problem in their town; 45% reported this for the London area.

Where do we need more public toilets?
% survey
% respondents
0 10 20 30 40 50 60 70

MEN WOMEN
Figure 5 – ‘No’ responses to question about whether there are enough public toilets in particular locations.
Figure 6 – Percentage of men and women reporting use of a back alley or bush when no public toilet is available
Residential areas Tourist areas Shopping centres Bus stations Tube stations Railway stations Parks
80 70 60 50 40 30 20 10 0
Never Ever Several times/yr
% respondents  0 20 40 60 80

Figure 7 – Reasons given for not using a public toilet, by gender
Concerns re safety
Concerns re drug use
Cost of entry
Lack of loo paper
Smell bad
Often unclean
Women Men
% respondents

3.3: Fluid
Over half the public restrict fluid intake in case they can’t find a toilet. Fifty-six percent of survey respondents reported restricting fluid intake either occasionally or frequently, due to concern that they might not find a toilet. Eleven percent reported that they restricted fluids more than once a week, rising to 13% among women compared to 9% of men. The highest proportion by social grade was in the semi skilled/unskilled group, with 15% reporting that they had to do this regularly.
3.4: ‘Loo leash’
The term ‘loo leash,’ sometimes also called a ‘urinary leash,’ refers to being unable to stray far from home, in case no toilet can be found. Two in five (42%) respondents reported that they have restricted outings on this basis, including 4% who have to do this more than once a week.
Strikingly, one in five of the general public agreed that they are ‘not able to go out as often as [they] would like because of concerns around a lack of public toilets.’ For those with an illness or condition requiring more frequent toilet use, this figure rose to above two in five (43%). Altogether these are alarming statistics with regard to health impact, and not insignificant obstacles to wider attempts to curb obesity, increase fitness and reduce health inequalities.
3.5: Reasons for not using public toilets
Some public toilets are excellent, well maintained and with an attendant on duty. Sadly this is not always the case and reasons given for not using a public toilet included lack of cleanliness, bad smell or lack of toilet paper, cited more frequently by women. There were also concerns about safety, drug use and cost
(Figure 7). restriction

3.6: Funding

The running costs of public toilets, according to local authority and other reports, vary between around £15,000 and £60,000 a year, depending on factors such as size and staffing by attendants. In the survey we attempted to tease out some viable options for funding, given the majority response that there should be a lot more public toilets.

Despite the consensus about need, few want to pay for them from their own pockets. For example, 85% agreed that councils (LAs) should have “a legal responsibility to provide public toilets which are free to use for the public”, but only 34% agreed that this should be via raising council tax. Such a proposal would also be unworkable without significant changes to the funding environment, following years of central government cuts to local authority budgets.

Between 2010 and 2020, councils will have lost almost 60p out of every £1 the Government had provided for services [LGA, 2019]. Unsurprisingly, the least popular option for funding public toilets was by entry fees (30%), but none of the offered options proved universally popular, with the exception of advertising in toilets (78%).

Business or charity sponsorship (62%), a generous benefactor (60%) and state funding in tourist areas (67%) were favoured. While benefactors do occasionally come forward, for instance for the toilets in Bridport, Dorset, funded by a local business woman, this is not a sustainable funding model at scale. Nevertheless, given the shortage of national or LA funds for these ‘necessaries’, it may be possible to offer tax breaks or gift aiding schemes to encourage both companies and individuals to sponsor local public toilets schemes.

The idea of taking a penny from the price of a bus, train or tube ticket was favoured by 45% of the public, while a tax on cafés and bars had the support of just over half (51%). State funding of toilets in tourist areas is not a new idea and local funding of this type is used in other countries, such as the USA.

3.7: Conclusions
Public toilets should be considered as essential as streetlights, roads and waste collection, and equally well enforced by legislation and regulations. This is important for all countries: the huge task of improving global sanitation should not eclipse the need for public toilets. The lack of provision is affecting equality, mobility, physical fitness and other aspects of health. However, our survey also demonstrated a central problem – no one wants to pay for them. It is high time to consider potential solutions.

4: Recommendations
I. The Government to make the provision of public toilets compulsory on a well planned and regulated basis. The time is right to deal with the astonishing lack of legal action on public toilets provision, as a matter of urgency – and for all those for whom urgency of need has not been addressed. This could be done through minor amendments to existing ‘permissary’ legislation, for example the most recent Public Health Act (1936). Where cities such as London have included public toilets in their plans, it may be possible to offer help and publicity to ensure that these are followed through without further delays.
II. Potty Parity Alongside this, ‘potty parity’ laws (as exemplified in the US, Canada and elsewhere [NY Times, 2005]) should be emulated in the UK to ensure fair provision in all areas. Equality of access to toilets includes the need for more unisex facilities, more toilets for women, and taking into account the needs of transgender individuals.

III. The Government to reverse years of funding cuts to local authorities and invest in our civic infrastructure.
A crucial prerequisite for the introduction of such statutory requirements regarding public toilets is the adequate resourcing of local authorities by central government. Councils are undergoing a financial crisis as a result of years of chronic under-funding: analysis by the Local Government Association shows that local services will face a funding gap of £3.9 billion by 2019/2020, rising to £7.8 billion by 2024/25 [LGA, 2019]. A proper funding settlement for local authorities is vital for ensuring adequate levels of public toilets provision, as well as positively influencing many other upstream determinants of health. The Government should use the forthcoming Spending Review to reverse years of shortsighted funding cuts, and properly resource local authorities.
Council Passes a Bill to Shorten the Line at the Ladies’ Room, New York Times Nicholas Confessore, May 26, 2005, accessible https://www.nytimes.com/2005/05/26/nyregion/council-passes-a-bill-to-shorten-the-line-at-the-ladies-room.html

IV. National and local government to pilot innovative new ways of financing public toilets, including a “spend a penny” campaign.
Recognising that public inquiries have failed to identify public toilets as a state or local funding priority, other ways to raise money to pay for toilets should be urgently considered, such as: • ‘Spend a penny’ levies on travel – a one-penny drawn from the price of every train and bus ticket to finance public toilets in the local area. This approach could be tailored to different regions, but as a rough indication of what it could finance in the capital, taking a penny on every London bus and tube journey corresponds to nearly 700 fully funded facilities – more than 20 new public toilets for every borough. • Donations on purchases, building on the success of this tactic by some charities and the successful introduction of a charge for plastic bags. • Sponsored activities and events. • Tax breaks for major donations to build or sustain a public toilet. • More advertising and optional purchases within public toilets or nearby.

V. Break down the toilet taboo
The taboo in discussing the serious aspects of toilet provision should be tackled by raising the profile of the subject, for example: • A conference in collaboration with charities that have sought to publicise the ‘toilet problem’. • Inclusion of the issue in fund raising events such as Red Nose Day and sponsored activities for charity, with emphasis on the health and social impact of the lack of provision. • An architectural competition to design the best public toilet in the UK – a ‘convenience’ suitable for our times – which could also serve as a tourist attraction. • A competition to find the best toilet jokes or limericks, to be publicised along with the lack of public toilets. The toilet taboo has led to a lack of public debate on the importance of this population health issue, and the way it disproportionately disadvantages certain groups, such as older people, women, and those with existing health conditions. Public health organisations have a responsibility to ensure the health effects of declining provision are publicised more widely, and that public toilets are recognised for their potential role in assisting hygiene, hydration, mobility and exercise. • All strategies and reports on obesity or physical activity to include reference to or recommendations on the levels of public toilet provision in parks and public areas. • Health aspects of deliberate dehydration or inadequate provision for those with greater need should be highlighted in reports on health and disability.

1. Stanwell-Smith R. Necessary nuisances: public health and the public toilet in London 1890-1910. Dissertation for the Diploma in the History of Medicine, Worshipful Society of Apothecaries, June 2011. 2. Photo Clarke & Lloyds property consultants – sourced from https://www.standard.co.uk/news/london/ money-down-the-drain-expublic-toilet-on-sale-for1-million-in-spitalfields-a3158681.html (accessed 02.05.2019) 3. BBC news online. Public toilets ‘wiped out in parts of UK’. Online: https://www.bbc.co.uk/news/uk36405414 4. Frizzell N. UK Councils are selling off public toilets. We need a loo coup. The Guardian, Thursday 6 June 2016. available at https://www.theguardian.com/ commentisfree/2016/jun/02/councils-selling-publictoilets-loo-coup (20.05.19) 5. Jones L, Schraer R. BBC Reality check: public toilets mapped. 15 August 2018. Online: https://www.bbc. co.uk/news/uk-45009337 6. Truckers’ Toilets UK. Newsletter for lorry drivers produced by Gillian Kemp. www.facebook.com/ TTUKcampaign 7. Smith M. Potty parity: would it be fairer to make women’s toilets bigger? [YouGov survey December 2017]. https://yougov.co.uk/news/2018/03/20/pottyparity-would-it-be-fairer-make-womens-toilet/ 8. Anthony KH, Dufresne M. Potty parity in perspective: gender and family issues in planning and designing public rest rooms. Journal of Planning Literature 2007; 21(3): 267-294 https://yougov.co.uk/topics/ politics/articles-reports/2018/03/20/potty-paritywould-it-be-fairer-make-womens-toilet 9. Ratio of male to female toilets, 2012. https://www. northernarchitecture.us/sport-architecture/ratio-ofmale-to-female-toilets.html 10. Davis AK. The hidden privilege in ‘Potty Politics’. American Sociological Association 2017 https://journals.sagepub.com/ doi/10.1177/1536504217732051?icid=int.sjabstract.similar-articles.3
11. House of Commons Communities and Local Government Committee. The provision of public toilets. London: The Stationery Office Ltd. October 2008 https://publications.parliament.uk/pa/ cm200708/cmselect/cmcomloc/636/636.pdf 12. Greater London Authority. An urgent need: The state of London’s public toilets. The London Assembly Health and Public Services Committee, March 2006. No longer available online, see Update Report July 2011. http://www.btaloos.co.uk/wp-content/ uploads/2014/01/FINAL_HPS_public_toilets_update_ report.pdf 13. Greed C. Inclusive urban design: public toilets. 2003. Oxford: Architectural Press. 14. Barkley M, Greed C. British standards revisions: more toilets for women and better toilets for all. Bathroom Today 2006; 2:42-43 15. Greed C. Overcoming the factors inhibiting the mainstreaming of gender into spatial planning policy in the United Kingdom. Urban Studies 2005; 42(4): 719-49 16. Cunningham S. Public In-conveniences. A practical guide to improving standards. Update September 2018. Online: http://www.publicinconveniences.org. uk/authors-comments/ 17. 17th Mayor’s Report to the Assembly. December 2017, pp26-27. Online: https://www.london.gov.uk/ sites/default/files/17th_mayors_reportv2.pdf 18: NHS Inform, Symptoms of dehydration, available at https://www.nhsinform.scot/illnesses-andconditions/nutritional/dehydration#symptoms-ofdehydration (accessed 20.05.19)” 19: Water, Hydration, and Health, Barry M. Popkin, Kristen E. D’Anci, Irwin, H. Rosenberg; Nutr Rev. 2010 Aug; 68(8): 439–458 20. CBS news report 2017. Online: https://losangeles. cbslocal.com/2017/10/18/portable-restroomshepatitis-a-outbreak/ accessed 20.05.19 21. Approximation based on the upper estimate of facilities running costs of £60,000 per year, and TFL data on journeys per year (accessible at https:// www.london.gov.uk/sites/default/files/bus_network_ report_final.pdf and https://tfl.gov.uk/corporate/ about-tfl/what-we-do/london-underground)

5: References
This report was lead-authored by Dr Rosalind Stanwell-Smith, trustee of the Royal Society for Public Health and Honorary Senior Lecturer at the Centre for History in Public Health, London School of Hygiene and Tropical Medicine.
The Royal Society for Public Health
John Snow House,
59 Mansell Street,
London, E1 8AN
www.rsph.org.uk
May 2019

For more information, please contact Toby Green – tgreen@rsph.org.uk
© RSPH 2019 Charity Registration Number 1125949
Twitter: @R_S_P_H Facebook: Royal Society for Public Health LinkedIn: Royal Society for Public Health

21 Months on and still no Bill to remove the Business Rates on Public Toilets

July 2020

The BTA continues to call on government to pass the legislation that has been agreed and supported by the House of Lords to remove the Non domestic rates levy from all Public toilets across the UK. The Bill was set before the Commons recently  but was rejected or defferred by this conservative government as the Coronavirus pandemic was taking thier concentration.

No thought or understanding appears to have been given to the fact that the re,moval of these rates would have given Local Authorities some additional monies to fight the pandemic by affording them the flexibility to put in additional supplies of soap and/or sanitizer – particuarly when the pandemic was at ots PEAK !!

Hpw many more months wll we have to wait to see the conclusion of this greatly needed legislation and when will this govwrnment wake up to the fact that Public Toilets are a vital piece of infrastructure and an essential service provision for all the citizens of our nation travelling to and from work and play and even more vital to the hundreds of thousands of visitors to our country who bring revenue and a much needed boost to local economies.

NOVEMBER 2019

PURDAH !!
Having been almost obliterated by the PM when he dismissed parliament a few months ago – we have been fighting to get this bill re-instated by the ministers. Unfortunately, with the calling of a General Election next month then parliament immedaitely enters a PURDAH period where no business can be enacted until a new government is established. So we’re back to SQUARE 1 or half way down the SNAKE…..who will catch us.

CANCELLED due to the recent illegal proroguing of Parliament

Although the government has been re-instated and business is returing to normal (?) the disappointing news was received that many of the pieces of legislation going through the two houses had been “DROPPED”
Government had retained the bills relating to the 2022 Commenwealth Games and also HS2 — but decided to get rid of the other bills including Education, Disability and Public toilets.

The BTA has been in regular contact with representatives of the MHCLG and will continue to fight for the re-intaement of the Rates Reduction Bill – at its earliest opportunity — Notes to follow.

PREVIOUSLY REPORTED

29 October 2018

Budget 2018: Chancellor announced Business rates cut for public toilets

Owners will no longer pay business rates on public toilets, the chancellor announced.

The BTA has been campaigning for nearly ten years to get some RELIEF for organisations providing this vital service to everyone. We were delighted to hear the chancellor speech (jokes and all) as it brought with it an opportunity for providers and suppliers to put some added revenue into cleaning & maintenance activities.

Publicly accessible toilets are VITAL to our everyday activities and in addition to being a total necessity for many user groups and individuals with accessibility needs – parents with young children and supporting the dignity and well-being of older persons – they bring extended relief for our tourism industry, day-trippers and the growing numbers of mobile workers travelling throughout the UK.

Philip Hammond revealed the policy in his Budget speech, joking it was virtually the only announcement that had not been “leaked”. We’re hoping the news will cascade across the borders and Scotland, Wales and Northern Ireland governments will quickly follow suit.

The relief will apply to any standalone facilities available for public use, whether publicly or privately owned.
The British Toilet Association has estimated that 40% of public toilets have disappeared in the past decade.

More than 600 public toilets across the UK have stopped being maintained by councils since 2010 and in 37 areas major councils no longer run any, according to figures obtained by the BBC.

Details of that report are ccontained in a deperate POST on this website

Local authorities are not legally required to provide toilets, so they are often closed as councils look to cut costs. Public toilets have traditionally been liable for business rates in the same way as other non-domestic premises such as shops and offices. MPs groaned as Mr Hammond made a string of toilet jokes, including saying that local authorities could at last “relieve themselves”.

The chancellor also promised to help High Street shops by cutting business rates by a third for all retailers in England with a rateable value of £51,000 or less.

Muscular Dystrophy UK is a charity for the 70,000 people living with muscle-wasting conditions in the UK, many of whom need access to Changing Places toilets. The charity brings together people affected by more than 60 rare and very rare progressive muscle-weakening and wasting conditions. Since 1959, the charity has been supporting families living with muscle-wasting conditions. They provide vital information, advice, resources and support for people with muscle-wasting conditions, their families and the professionals who work with them.

Since November 2017 Muscular Dystrophy UK have been co-chairs of Changing Places Consortium alongside PAMIS.

For further information please contact:
Clare Lucas
Muscular Dystrophy UK,
61A Great Suffolk Street,
London
SE1 0BU
Tel: 020 7803 4838
http://www.musculardystrophyuk.org/

working in partnership with

Centre for Accessible Environments
Holyer House
20-21 Red Lion Court
London, EC4A 3EB
EMail: info@cae.org.uk
Telephone: 020 7822 8232

Government investment of £2million for Changing Places toilets at motorway service stations

Today, the Department for Transport has launched its Inclusive Transport Strategy.

USE OUR LOOS!

Mumsnet was conceived in early 2000 when JustineMumsnet embarked on a disastrous family holiday. Her idea was to create a website where parents could swap advice about not just holidays but all the other stuff parents talk about.

Nineteen years later and who’d have thought it would come to this? Mumsnet is now the UK’s biggest network for parents, with around 10 million unique visitors per month clocking up around 100 million page views.

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