Stoma: Public Toilet Provision

Peter Dowd Excerpts

Thursday 18th June 2026 Westminster Hall

[Mr Andrew Snowden (Fylde) (Con)]

It is a pleasure to serve with you in the Chair, Mr Dowd, especially on what I think is your birthday—thank you for choosing to spend your special day talking about public toilets with us. I also thank the hon. Member for Strangford (Jim Shannon) for calling this important debate. Not only is he the most industrious contributor to debates and question times across this House, but he champions matters that really cut to the heart of why we are here and that really matter to people in their everyday lives.

Anyone who has supported a loved one, family member or friend who has gone through the process of requiring a stoma will realise that you often do two things together: laugh and cry. If you do not do the laughing, you will just spend all your time crying. As hon. Members can probably already tell, this is quite a personal subject for me. A little irreverence and humour is a good way of dealing with the issue of stoma care and inflammatory bowel disease. In fact, I would say it is essential. It also helps to break down the barriers and the embarrassment of talking about the subject in the first place.

We have had a good explanation of what a stoma is, namely a surgical opening to allow waste to leave the body. It usually comes at the cost of having significant amounts of intestine, or in many cases the entire colon, removed, which is as painful, damaging and difficult to recover from as you would imagine. However, the conditions that often lead to someone requiring a stoma involve—let us be honest—talking about poo, and the British public are not particularly comfortable talking about. So although the hon. Member for Strangford has outlined what a stoma is, most people are embarrassed about them. As I said, one way people get around that is by having a sense of humour. I have met many people with stomas; a very close loved one has a stoma, and I have met many of the friends she has made over the years during her many hospital stays.

Among the things I have picked up on is what you call a stoma once you have one. The names are quite creative, and the naming process is, first, quite humorous and, secondly, about a degree of taking ownership of it. I will run hon. Members through some of the names that people come up with for stomas, so that we get beyond just a “surgical opening”. Some are ones that I have seen in research, and some are from people I know who have a stoma. Most of the names are a play on words, such as a rhyme with stoma, or references to poo or pumping—apologies to Members in advance, but hopefully there will find something in this for one of you.

As an opening gambit, there is Paloma Faith, which is a good name for a stoma. Winnie the Poo is another one. Another favourite of mine is Vladimir Poopin, just because it takes the mick out of a dictator. To take something straightforward and simple, there is Windbag, which is pretty much what we are talking about. Captain Craptastic is another good one. Others include Donald Trumps and Bilbo Baggins. Finally, my favourite is Louis Shitton, which I think is excellent—I am delighted to have got that into Hansard. I hope that that gives a bit of insight. People who have had to have a stoma because of their suffering have been through difficult times, but they are remarkably resilient people, many of them with a great sense of humour.

Every Member in this House will have a constituent who has inflammatory bowel disease, colonic cancer or another of the conditions that leads to a stoma, and we will all have constituents with stomas—that is beyond doubt. Many conditions can lead to people requiring a stoma, although that will depend on how controllable a condition is in any individual person—whether they get Crohn’s or colitis flare-ups or whether the cancer is caught and treated early enough. Given all those things with a similarity of issues, Members will have hundreds, if not thousands, of constituents who have a stoma or who know someone directly affected.

The conditions themselves are embarrassing. It is not just about having a stoma, when you have got to that point; by the time you get to having one, you have usually been through years of having to deal with a condition and having to suffer it in silence, because you do not want to talk about it. There is also a lot of misunderstanding; a lot of people think that Crohn’s and colitis, for example, are some form of irritable bowel syndrome. Even well-meaning people suggest eating less spicy food or not eating brown bread, because they do not realise that the condition generates internal ulcers in the most painful place they could possibly be, and that those bleed internally, creating internal blood clots that need to pass through your system urgently, in an incredibly painful way—whether you had a Madras on Friday night makes absolutely no difference to that condition.

Toilet provision is so important for people with stomas as well as those with the conditions mentioned. That is important to remember, because we can look at the number of people with stomas—Colostomy UK has provided a helpful briefing ahead of this debate—but that would give you a very distorted view about the total number who require access to toilets due to health conditions.

As other hon. Members pointed out, when someone who has a stoma goes to the toilet, they are either going to empty it or change it. Changing it is not a quick thing and if there is a leak, which is something anybody with a stoma lives in absolute fear of, that needs to be urgently dealt with. Visualise where that would be on your body. Even if just emptying it, the proximity to the toilet means also getting very close to the floor and the toilet itself. People suddenly become experts in the cleanliness of toilets and which companies keep clean toilets and which do not. It goes back to remembering the human in all of this, and not just taking it from a purely clinical and public health perspective.

Imagine going through years of dealing with a health condition that leads to needing major surgery that is life changing and life threatening in its own right and results in a stoma. Regardless of your age, but especially for younger people in this hyper body conscious world, that is not something that you want—it is not something that you are proud of—and it is something that you are often embarrassed about and will try and conceal and hide. Imagine having been through all of that and having recovered and just about psychologically coming to terms with having a stoma—and you want to go out. You want to pick up the courage to go out. You find some clothes that for the first time you think cover it so you do not feel self-conscious about it. You go out, you feel sexy, you feel confident. It is a big boost. Then you either need to empty the bag or have the dreaded leak, and there is nowhere to do anything about it.

As one of my friends—I apologise in advance, Chair, but I am quoting—said:

“Imagine getting dressed up for date night and then having to go and crawl around on a piss covered floor simply to change your bag.”

Would that do anything other than knock your confidence, dignity and self-respect? It is not fair.

There seems to be a general consensus among forums and things I have read that we men need to have a little more care and attention in toilets than women do and that the standard in male toilets is often significantly lower. However, it is a point none the less. That is what I want to get across in this debate; I do not want to talk about the stats, figures and percentages. Every one of those numbers has a human being behind it who is trying to get on and rebuild their life under immense physical, psychological and emotional damage. That is what makes this so important.

There are also other issues including access to private toilets. All of this cannot fall to local councils. I have been working and campaigning on this since I was elected as a county councillor in 2017. I moved a motion in full council—those were the days—around access and the card that people can carry that says they need access to the private toilets in a commercial facility.

We have our own experiences of that in our family. These are pre-stoma but they highlight the conditions as well. When shopping you suddenly feel the urge to go, and, as we have already established, you are not having a poo or a pump but are passing blood clots in an incredibly painful way and your body is trying to get them out of your system and you cannot contain it, and poo will come out with them. You are shopping and have decided to go out—even though, as hon. Members have already highlighted, a lot of people plan their journeys around that—you show your card to a member of staff and they point-blank refuse to let you use the private toilets. You soil yourself in the middle of the shop, and then you do not go out for a long time afterwards because of the embarrassment.

I do not want to name or shame any individual companies that may have been involved in that example, but if I say that their slogan is “You can do it if you…it”, Members can draw their own conclusions. That chain was horrific. From my lobbying, I believe it has got an awful lot better of late. It is about raising understanding in organisations of what the cards are and why people carry them. That goes back to stigma and the “Not every disability is visible” campaign, which I pushed to be rolled out across Lancashire all those years ago. These conditions are not visible. Someone may look physically well but experience that urgency. We must make sure that people with stomas, advanced Crohn’s, colitis and so on know that they can get a RADAR key.

People need to know where the toilets are. Lots of different people have tried this in lots of different ways. We already accept that councils cannot be responsible for providing a toilet in all places at all times. If someone is going to go out and they are dependent on toilets being nearby, they need to know that there is a network of companies and commercial organisations that will let them use their toilets, even if there are not a lot. It is just about pubs and hotels knowing that sometimes, someone may need to come in. I know it is really annoying when non-paying customers come in and use the toilets, but having those apps is important so that people can plan their days out and their journeys with confidence.

There are knock-on benefits to the NHS and public health of helping people to have and maintain normal lives post traumatic bowel surgery and helping them with the psychological recovery. If they had to quit work, that could help them to get back into work. Stomas can be noisy. They rumble and pump. They are bowels, just on the outside of the body, or moving to the outside of the body. Dealing with that is hard enough. Therefore, people may not wish to empty or change a bag at work. They may wish to go somewhere near work to do it. They may work on the tools, in an outdoors job where they do not have routine access to toilets.

There are knock-on benefits to the Government and to the Treasury of helping people back into work, stopping people becoming ill with mental health issues from lack of confidence and emotional damage, and helping people to manage their condition better so that they are not continuously spiralling and going back into the NHS. It is not just about doing the right thing and the moral obligation to those people.

The hon. Member for Strangford has already outlined Colostomy UK’s requests for things that could be advanced through building regulations to make toilets more stoma-friendly and the general need for more public toilet provision. I am sure it will continue to lobby effectively on that. A lot of the time, this is about the role the Government can play in creating awareness among public bodies and organisations about why this is important—the human element that I have tried to outline. This is about people’s lives and the quality of life of some of people who deserve our support the most. It is about simple things, such as making sure that councils have nice, clean toilets, that toilets are open and that people can access information about where public and IBD-friendly toilets are.

I am about to start repeating myself, so I shall end my speech, which is probably a personal best for inappropriate Hansard contributions—I look forward to reading them back. Once again, I thank the hon. Member for Strangford for securing this debate. This really is an important topic, and I know the debate will mean a lot to people. As I said, a lot of people with these conditions do not want to talk about it. They want to hide it. They suffer in silence. Their voice will not be heard. They will not contact their MP to ask if they can have better public toilets as they have a stoma or IBD, because they do not want people to know. It is therefore really important that we, as their elected representatives, are their voice. I hope that we can be their voice today, and I look forward to what the Minister and shadow Minister, my hon. Friend the Member for Mid Bedfordshire (Blake Stephenson), have to say.

[Peter Dowd (in the Chair)]

I call the Liberal Democrat spokesperson.