Social Justice

'I urinated myself in the opticians': UK's public toilet crisis makes disabled people feel like 'prisoners'

More than a decade of austerity has led to a dramatic drop in public toilets. And it is having a heartbreaking impact on disabled, homeless and vulnerable people

public toilet

There has been a loss of 60% of public toilets in the UK since 2011, and some of those that still exist are not clean or hygienic. Image: Unsplash

Yinka barely steps outside because she is afraid she will urinate herself. On the rare occasion she leaves the house, she starves and dehydrates herself the night before. She is isolated. And she blames a public toilets crisis across the UK. 

“I suffer from depression,” she says. “I cry. I’ll be bubbly in front of people but, when I’m on my own and at night and it’s all quiet, I feel so sad. I have no life. I don’t want to upset anybody, but I feel like I’m the living dead. What is my purpose in life? I can’t go out.”

The British Toilet Association (BTA) estimates that nearly 60% of public loos have been lost since 2010, mostly a result of slashed council budgets. Councils faced a £15bn real-terms reduction to core government funding between 2010 and 2020 and toilets were one of the first sacrifices.

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“There is no legal requirement on any local authority in this country to provide toilets,” Raymond Martin, the managing director of the BTA, says. “And because there’s no legislation, there’s no additional funding. Councils suddenly had to make significant savings. They had to clean the streets, empty the bins, bury the dead, look after schools and roads, but not toilets.”

It has worsened at a dramatic pace in recent years. The pandemic shut almost all public toilets and, while they are slowly recovering, Liberal Democrat research shows that the number of loos has fallen by 14% since 2018. 

“It is human dignity,” Martin says. “You’re abusing people’s rights. Toilets are something we need as a human species. We have to get rid of the poisons. When we eat and drink that turns into poisons and urine and we have to get that out of our bodies otherwise we get sick.”

Yinka, who suffers from incontinence and irritable bowel syndrome, gets anxious every time she has to go out. She admits she has urinated herself in the opticians before, with the nearest public toilet 15 minutes away. “It is a very lonely place,” the 63-year-old says. “I feel like I’m in a black hole. This is not how I envisaged my life. It is really bad.”

Recent research from bladder care company Jude has found that 67% of women and half of men have deliberately dehydrated themselves as a result of no toilet access. And 41% of people say this has led to health issues such as urinary tract infections, bladder and kidney problems. 

“As a human species, there are five things we need to do to survive in order to live,” Martin says. “We have to eat, sleep, drink, breathe and go to the toilet. Failure to do any one of those five things makes us sick, dizzy, disorientated and that can lead to high blood pressure, stroke and in the end death.”

Yinka’s health is worsening. “I’m prone medically to having blackouts. What am I doing to myself when I can’t eat or drink before I go out? I’m stressed. I’m nervous. And that makes you want to pee anyway. That doesn’t help.”

Jude has published new research showing the emotional impact of the “public health crisis”. Image: Jude

Around 60% of women and more than half of people surveyed by Jude feel stressed, worried, anxious or panic-ridden when they cannot find a public toilet. And 37% of people have hesitated on or cancelled going out to cope with a failure of public toilet provision. 

“Taking a leak is not a luxury, it is a basic human necessity,” Peony Li, founder of Jude, says. “We’re looking at a public health crisis but one that is far too easy to cover up thanks to the complex issues associated with needing the toilet – an invisible issue steeped in shame and embarrassment. We’re here to change that and raise awareness of this problem that needs urgent attention.”

​​Backed by the National Key Scheme, Disability Rights UK and The Great British Public Toilet Map, Jude is calling on the government to acknowledge that poor toilet provision is a public health crisis.

Rebecca Ruane, who suffers with pancreatitis and also struggles with the lack of public toilets, says: “People hate talking about toilets, let alone their own bowel habits. As much as I’ve had to get used to it because of my annual review with my pancreatitis team asking me what my stools are like, it’s funny the reaction you get from someone who isn’t used to it.” 

When Ruane mentions the word ‘stool’, people often make a comment about how it’s good they are not eating. And there will be times where she has to cut the queue for the disabled toilet and people look at her disapprovingly. It is this lack of understanding Ruane wants changed. 

“Talking about your toilet habits isn’t something that you should keep to yourself,” she says. “It makes it harder to then ask for help and people see it as something dirty. A lot of digestive issues are invisible illnesses. You can’t see it. It’s that awareness piece of opening up to being more comfortable talking about it. These conditions exist and people need to be more understanding and accepting.”

Karen Irwin, a specialist nurse and service manager at Bladder & Bowel UK, says: “We hear everyday from people who rely on public toilets for comfort, dignity and health. Public loos are not conveniences or luxuries, but are absolutely essential for hygiene and social reasons – and this only becomes more urgent for people with bladder or bowel problems. 

Rebecca Ruane, who was supported by Guts UK. Image: Supplied

“We know that 14 million people in the UK have some degree of urinary incontinence, while over half a million adults have faecal incontinence. A lack of public toilets can lead to social isolation and anxiety for millions of people, not to mention the obvious public health concerns.”

Ruane has noticed that there are fewer restaurants and businesses which allow people to use their toilets without buying something. But people with disabilities already face extra costs of around £975 a month, according to estimates from charity Scope. 

The National Key Scheme offers disabled people independent access to more than 10,000 locked disabled toilets around the country, which Ruane supports and believes should be used more widely. “But actually, people shouldn’t have to use that,” she says. “People should just generally be more understanding.”

Yinka agrees that the radar key is important but without enough toilets in close proximity, it is no use. “You have to go into the bush where nobody sees you,” she admits. “It has got to the stage where I don’t even care anymore. If I have to do a wee in the park, none of them have facilities and they’re all open so you can’t really find a bush to hide. If I have to squat, I’ll squat, but it’s humiliating.”

Martin says people are increasingly being forced to urinate and defecate in the streets. “That’s literally transmission of disease,” he adds. “It’s possible anybody coming to clean that or someone kicking it up into the air could be helping to transmit a deadly virus.” 

People experiencing homelessness are hugely impacted. Public toilets are a place they can wash, refresh and relieve themselves in the day and night, but many are only open at limited times. 

Public toilets are open for a little more than 10 hours a day on average, according to the Liberal Democrats. One public toilet in Harlow, Essex was open for just four hours each day. Thanet council in Kent had the lowest average opening times for their public toilets at just 5.5 hours.

“This is yet another example of our local communities up and down the country being abandoned by this Conservative government,” Helen Morgan, the Liberal Democrat local government spokesperson, says. “People deserve these basic facilities and yet they are being let down. 

“Ministers have, for years, savagely cut local authority budgets and now we are seeing the erosion of local facilities like public toilets. We need real and targeted funding to ensure local people are getting the fair deal that they deserve.”

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The problem is, toilets cost money. The British Toilet Association estimates they cost anywhere between £3,000 and £5,000 each year to run – and some cost up to £30,000 if they are larger. “The biggest problem is getting them clean and getting them hygienically clean,” Martin adds. “And that’s where councils are struggling, because they don’t have the staff.”

Yinka used to work as a cleaning manager in a call centre scrubbing down toilets, and she feels cleaners are often wrongly blamed for laziness. She could spend hours cleaning a toilet, only to have it ruined by the public in minutes. “So who do I blame?” she asks, “I blame everybody. I blame all of us, because we all need to look after our facilities.”

Jude launched a Golden Loo campaign, installing a bright golden Portaloo in Covent Garden. Image: Jude

Martin believes “we should be paying somewhere between 75p and a pound to use a toilet because there’s a cost to providing that service”.

Yinka would be happy to pay for the service if it meant there were more toilets, but she doesn’t believe that she should have to pay for something which is a human right, especially as disabled people already face greater costs. And that cost is not just monetary but physical and emotional.

Dr Chris Chatterton at Pad Project UK says: “Lack of public loos means that many people with incontinence fear going out and stay at home. Pads are available through the NHS, but many people don’t qualify, so buy them privately.

“Yet these are expensive, forcing people to ration their use, and again this can lead to individuals having to stay at home, with incontinence pad poverty having a big impact on mental wellbeing.”

Julie Harrington, the chief executive at Guts UK, adds: “For those living with digestive conditions, lack of public toilets can force people to spend more time at home, leading to feelings of isolation and loneliness.

“There are millions of people in the UK alone living with a digestive condition and many plan their day and journey around having access to a nearby toilet. Our nation should have the comfort of knowing that if we have the urge to go to the toilet when we are out in public, that we have somewhere to go.”

The result of this can be tragic. “If you don’t have toilets, then people become prisoners,” Martin says. “People can’t go out and socialise the way they should. They can’t go out and spend their money. So it has a major effect on the local economy.”

Yinka feels this deeply. “It’s almost as if they have taken my dignity away. I have no choice. I can’t wake up like everyone else and just get the bus down the high street because everything has to be perfectly planned. 

“I don’t go to the high street more than two or three times a year, and that’s if someone is chaining me and dragging me down there for doctors appointments and opticians and dentists.”

She is being supported by Jude and has found an online community of people who are also facing the same harrowing experiences she has faced. But until there are more public toilets in her area, Yinka does not have much hope for the future. 

“I’m isolated. I feel friendless. Without going places or having some kind of social life, it is horrible. I don’t understand this concept of having no toilets.”

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