Stoma: Public Toilet Provision

Tom Gordon Excerpts

Thursday 18th June 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered public toilet provision for people with stoma.

Thank you for standing in, Mr Dowd. It is much appreciated by us all. It is always good to have you in the Chair, no matter what, but today is a special occasion. This is not what I would call a particularly fashionable debate, but it is one that affects many people and it needs to be aired in Westminster Hall so we have the opportunity to put forward a case.

Throughout my life, I have had occasion to engage with people who have stomas. I never quite understood what they were, other than that there was something wrong with their bowel system and a stoma as a method to give them a normal life, if that is the right way to put it. In some cases, the stoma was there for only a short time because the person recuperated. Sometimes their body needed a bit of rest, and perhaps that was one way of doing it.

I am pleased to have secured this debate, and I am grateful to the colleagues who have come along to participate. I also place on the record my thanks to Colostomy UK for its support in preparing for the debate and, more importantly, for the work it does every day to support people living with stomas across the United Kingdom. I recently had the opportunity to meet representatives from Colostomy UK to learn more about the challenges it faces, and the challenges faced by patients living with stomas. The discussions highlighted an issue that many of us rarely think about, but it affects thousands of people every single day. This debate is not just about public toilets for those with stomas. At its heart, it is about dignity, independence and inclusion. Those are the three themes that I wish to put on the record.

I apologise for not saying at the beginning that it is lovely to see the Minister in her place. I understand that this is her first debate, and I wish her well in her new role. We will not be hard on her—that is not in my nature—but we will collectively put forward a case, and she will respond in a positive way to encourage us on what we are asking for. I have four asks for her to look at.

For most of us, access to a toilet is something we take completely for granted. We leave home to go to work, visit friends, attend events, go shopping and go travelling without giving it so much as a second thought, because there will always be a toilet. That reminds me of a story. When I was in the armed forces parliamentary scheme, John Spellar, who used to be a Member, told me that he had two pieces of advice when we went on a course—he always gave good advice. He said, “If you see a toilet, go, and if you see food, eat.” Those were the two things he told me to do whenever I went anywhere, and I have always remembered his words of wisdom. The fact of the matter is that I did not have a stoma, so I could go to the toilet anywhere, but it becomes a great problem for those who have a stoma.

We assume that if we need a toilet, one will be available, but the many people living with a stoma do not have that certainty. That is the key theme of this debate. For the benefit of those following, a stoma is a surgically created opening in the abdomen that allows waste to leave the body into an external pouch. People may require a stoma following bowel cancer, Crohn’s disease, ulcerative colitis, diverticulitis, trauma or other serious health conditions. I have had a couple of friends over the years with Crohn’s disease and one with colitis. For a short period of their life they had a stoma, which helped them to heal and eventually they were able to do without it.

For many people, a stoma is lifesaving surgery that allows them to have a comparatively normal life. It enables them to regain their health, maintain their independence and continue living active and fulfilling lives. Having a stoma should not mean they cannot do that; it just means they have to deal with the toilet issue.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I thank the hon. Gentleman for securing this important debate and raising awareness of this issue. Anyone who was at Prime Minister’s questions last week will have seen me talk about living with ulcerative colitis. I am grateful that the Prime Minister has arranged for the Minister to meet me to talk about the issues that people with inflammatory bowel disease face. If the hon. Gentleman or anyone else is interested in trying to join that meeting, should the Minister allow it, I would be more than happy to include them in that conversation.

[Jim Shannon]

I thank the hon. Gentleman, and I will take advantage of that opportunity if it comes.

More than 200,000 people across the United Kingdom live with a stoma. For some, it may be a short-term issue, their body may heal and they will recover—that is to be welcomed. However, there is a lot of anxiety for those who have to live with a stoma even for a short time. Many find that something as simple as leaving home can require careful planning and considerable anxiety. One of the strongest messages I took away from my discussions with Colostomy UK is that many people living with a stoma plan their life around toilet access. It is a fact of life, and if they are going to a restaurant or a shopping centre, or if they are going on a journey, they have to make sure there is toilet provision.

[Tom Gordon]

I thank the hon. Gentleman for being so generous with his time. He listed restaurants, businesses and other places where one might find a toilet. In recent years, we have seen the hollowing out of local government and the loss of publicly accessible toilets provided by town councils, unitary authorities or whatever it might be. Does he agree that when local authorities look either to close or to charge for those facilities, they need to consider the impact on people with stomas and other IBD conditions?

[Jim Shannon]

The very poor provision of toilets is an issue I will address shortly. Fortunately, we have been proactive in my constituency, which may be something that others wish to follow.

The availability of a suitable toilet can determine whether a person feels confident enough to attend a family gathering. When all the family is there and the kids are running about, they wonder, “Is the toilet handy?” or “Are there two toilets, if somebody is in one, because I need to make sure I get there fairly quickly?” It determines whether they can enjoy a day out, travel for work, visit a town centre or simply spend time with friends. It is not a situation any of us would wish to see.

Evidence gathered by Colostomy UK highlights the significant scale of the issue. Its Stoma Aware survey found that 62% of people living with a stoma avoid activities that many of us take for granted because suitable toilet facilities are not available. One in four had been challenged for using an accessible toilet, despite having a genuine need to do so. Most concerningly, 4% said they left home only for emergencies. Those figures are striking. It seems that they are almost a captive in their own house.

The figures tell us that this is not an issue of convenience, but of social participation, confidence and, for many people, isolation—isolation is the key issue. In this House, we spend a great deal of time discussing loneliness and social isolation, to which the Government rightly respond positively by trying to make the situation better. We talk about encouraging people to remain active in their communities and ensuring that those living with long-term health conditions are not left behind, yet, as the hon. Member for Harrogate and Knaresborough (Tom Gordon) said, inadequate toilet provision can be a significant barrier to those ambitions, affecting the way a person plans their day, their journey or their outing.

If someone cannot be confident that they will find a suitable toilet when they need to, they may begin to avoid situations that others take for granted. They may stop attending social events, going to family occasions, travelling or visiting friends and family, or they may avoid shopping centres, cultural events or community activities. “If I go there and am caught short, where do I go? Is there provision? How far can I travel?” It is not that they lack the desire to participate, but that they are concerned about the predicament they might find themselves in because they lack confidence that the facilities they need will be available.

People living with stomas can also experience complications that require immediate access to a toilet, such as leakage, pancaking or ballooning. Those can happen without warning and often require urgent attention. I remember when one of my friends was caught short unexpectedly and went to the toilet. The problem was that his stoma had overflowed. Apart from the embarrassment, the people around him did not quite understand what was going on. For my friend, especially, it was incredibly worrying. Such situations can happen without warning and often require urgent attention, so when they occur, having access to a suitable toilet is not a luxury but essential—“We must get there right now.”

I have heard some of the comments made by people who responded to the Colostomy UK survey. One respondent said:

“I plan every journey around toilets. Sometimes I cancel plans because I can’t face the stress”.

That is the stress of not knowing whether a location has a toilet, whether they will have access to it or whether there will be a problem.

Another respondent said:

“I once had a woman yell at me for using the accessible toilet because I looked fine”,

and she could not understand what was going on. The respondent did not go out again for weeks because of the fear of having to deal with somebody else who might shout at her, maybe saying worse things.

Those comments are a reminder that many conditions are invisible. People should not have to justify their need to use an accessible toilet, nor should they be challenged at any time when doing so. The impact extends far beyond physical inconvenience; it affects confidence, wellbeing and quality of life.

It strikes me that the solutions to this issue are neither complicated nor expensive, so I have some thoughts to put to the Minister on how to move forward. We are not talking about major infrastructure projects or significant new financial burdens. In many cases, we are talking about practical measures that can make a substantial difference to people’s lives. The challenge is not a lack of solutions, but ensuring that those solutions are consistently available and embedded in policy and practice.

That brings me to the two key issues I wish to raise with the Minister. The first concerns public toilet provision. Across the United Kingdom, public toilets have disappeared from town centres and public spaces. Communities that once had facilities on which people could rely have seen those facilities close, often without any indication that they will be replaced. That issue is well known. The hon. Member for Harrogate and Knaresborough referred to it in his intervention, and it will be commented on by others.

[Tom Gordon]

I commend the hon. Gentleman on being one of the most generous Members I have encountered. On the provision of public toilets, the issue is not only the toilet closures, but the lack of maintenance and spending to make them a toilet that someone wants to use. Does he agree that we need to make sure that, where we have those facilities, they are up to the standard that anyone, let alone someone with one of these conditions, should expect?

[Jim Shannon]

That is, again, an incredibly powerful intervention from the hon. Gentleman, who is very focused on the issue. The toilet should be of the right level of cleanliness, and with the relevant attendance, so that it can be used by everyone.

The wider decline has been highlighted by the Royal Society for Public Health, which has warned of the emergence of public toilet deserts in the UK. Recent research found that there is now one public toilet for every 15,500 people in England and that public toilet provision has fallen by 14% since 2016. That is incredibly worrying, and highlights the importance of this debate. It is also why my requests to the Minister will be fairly specific.

For many people, the lack of provision may simply be frustrating; for somebody living with a stoma, it can be life-limiting. It can influence where they go, how long they stay and whether they feel able to leave home at all. Public toilets are not simply a convenience for many people: they are essential infrastructure and an essential part of everyday life. The Royal Society for Public Health has warned that, for some people, access to a public toilet can be the difference between whether they leave the house or not. That is the reality that Colostomy UK hears from people living with stomas.

I do not set aside the financial pressures facing local authorities, and I appreciate that there are difficult decisions to be made, but I hope the Minister agrees that nobody should be excluded from public life because they cannot access a suitable toilet when they need one. I therefore hope the Government will consider how local authorities can be supported to ensure that people living with stomas and other long-term health conditions are not disadvantaged by a lack of public toilet provision. I also hope the Minister will consider whether the current discretionary approach to public toilet provision is sufficient for those who rely on these facilities to participate in everyday life.

The second issue I wish to raise is separate but equally important. The first issue is whether people can find a toilet at all; the second is whether, when they do find one, it is suitable for their needs. That is key. Even where accessible toilets exist, they do not always meet the needs of people living with stomas. A toilet may be accessible from a mobility perspective, but may still lack the practical features needed by somebody managing a stoma, as the hon. Member for Harrogate and Knaresborough outlined in his three key interventions.

As I mentioned earlier, I am fortunate to be the hon. Member for Strangford, but I also represent the largest part of the Ards and North Down borough council area. What the council has done, which I have supported over the years, is so important and is perhaps a blueprint for other councils to follow. It has worked with Colostomy UK on a strategy and a process to upgrade all accessible toilets in council-owned facilities and make them become stoma-friendly. In doing so, it became the first council in Northern Ireland to make all accessible toilets within its facilities stoma-friendly, demonstrating real leadership on this issue. Ards and North Down borough council—the council I served on for some 26 years—has led the way, and I hope others will take forward its policy.

The improvements include practical additions such as shelves, mirrors, hooks and appropriate disposal facilities. As the hon. Member for Harrogate and Knaresborough referred to in his intervention, that is one way forward. Those may sound like small changes, but they make a significant difference to people managing a stoma. I commend the council for recognising the needs of people living with stomas and for taking practical action to improve accessibility across its estate.

The fact that the first council in Northern Ireland has already implemented changes demonstrates that they are achievable and can be delivered within existing public sector budgets. The council delivered those special features in the toilet facilities it has in my constituency. That is particularly encouraging, because it demonstrates that the solutions being proposed are practical and achievable and can be delivered. The council recognised the need, worked with people who understand the issue and implemented changes to make public facilities more accessible. The question we should ask ourselves is this: if we recognise that these features are necessary, why should their provision depend on the goodwill of individual councils, businesses and organisations? Should they not become the standard that people can expect?

As things stand, provision is inconsistent. Some facilities include those features, while others do not. As a result, people living with stomas cannot be certain that an accessible toilet will meet their needs. That is why Colostomy UK is calling for stoma-friendly features to be incorporated in part M of the building regulations and in future accessibility standards. These are constructive policies, put forward so that people with stoma bags are able to have a better quality of life.

The success of Changing Places toilets shows what can be achieved when the Government identify a genuine accessibility need and respond positively. The features required to make a toilet stoma-friendly are modest, yet they can have a profound impact on people’s daily lives. I therefore believe that there is a strong case for examining whether stoma-friendly features should become a standard requirement for accessible toilets in any new developments.

The Minister has already seen them, but before I conclude I have four specific questions for her. First, will she agree to meet Colostomy UK to hear directly from people living with stomas and discuss their issues further? I understand and appreciate that she has only just taken over, but if she could make the time, we would appreciate the opportunity to act on this issue.

Secondly, on public toilet provision, will the Minister engage with her ministerial colleagues in the Ministry of Housing, Communities and Local Government to explore how local authorities can be supported to maintain adequate public toilet provision for people with stomas and other long-term health conditions? There are many pertinent long-term conditions, which the hon. Member for Harrogate and Knaresborough referred to in one of his interventions.

Thirdly, on building standards, will the Minister ask officials to examine whether part M of the building regulations could and should be updated so that stoma-friendly features become standard for accessible toilets in new developments? Fourthly, will she work with Colostomy UK and other stakeholders to ensure that people living with stomas are able to participate fully in work, education, travel, culture, community life and, indeed, normal life?

Let us be quite clear: this is not a party political issue. In the debates that I bring forward, I try to never make it about that, because it is not; it is about the people. It is a practical issue, an accessibility issue and, above all, a human issue. No one should feel excluded from society because they cannot access a suitable toilet when they need one.

I look forward to hearing other Members’ contributions, and I thank the hon. Member for Harrogate and Knaresborough for his interventions. I look forward to the contributions of the shadow spokespeople, the hon. Members for Mid Dorset and North Poole (Vikki Slade) and for Mid Bedfordshire (Blake Stephenson), and I really do wish the Minister well in her role. Today we have the opportunity to work collectively to do better for our people.