Stoma: Public Toilet Provision

Vikki Slade Excerpts

Thursday 18th June 2026 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve with you in the Chair, Mr Dowd. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate.

It is great to follow the hon. Member for Fylde (Mr Snowden), who did better than I did in my maiden speech, when I managed to mention Shitterton and Happy Bottom—and I have now done so in Hansard for a second time. By the way, they are both places in my constituency. When I first stood for Parliament in 2015, the closure of public toilets was one of the key issues raised with me by local people. In fact, we pretty much had a whole hustings on it at Canford school.

Since arriving in this place I have repeatedly sought opportunities to improve provision, whether through debates or legislation. I am therefore delighted to speak today in a debate focused on people living with stomas, although many of the issues we are discussing apply equally to people with other conditions or disabilities or, indeed, other sections of our community. For many people, the worry about whether a public toilet exists, is open, clean and has the facilities they need is lifechanging. It is the difference between participating in public life or staying at home.

This issue is close to home for me, as one of my close family members needed a stoma last year. It stopped them travelling into London to watch me speak in Parliament and it will even stop them travelling to see their grandchild perform in the west end in a few weeks’ time. I know they desperately want to enjoy those experiences, along with the rest of the family, but they feel trapped close to home and close to the facilities they know they can rely on.

Following the hon. Member for Fylde, I will have to ask my family member what they call their stoma. Given the prevalence of bad jokes that emanate from their home on a daily basis, I am sure they will come up with something. I may need to catch the hon. Member in the Tea Room and let you know what they come up with. Simple changes, such as shelves, mirrors, disposal bins, hooks and space to manage the stoma with dignity, can cost such a small amount but make such an enormous difference.

That is why the Liberal Democrats are calling on the Government to support further research into the adjustments that could promote the dignity, comfort and independence of people living with stomas. I would be interested to hear the Minister’s views about potential changes to part M building regulations, as suggested by the hon. Member for Strangford. Too often, these small facilities are absent or even removed for fear that they might be misused for other purposes.

It is shocking that more than a third of stoma users report being challenged or criticised for using accessible toilets because their condition is invisible. Two thirds of all disabled toilet users have experienced disapproving looks and almost half have been verbally challenged. Imagine how distressing it must be, particularly for someone recently diagnosed with a life-changing condition who might already be worried about getting to a toilet on time, to face the judgment of strangers.

For people with stomas, older people, those managing disabilities or continence conditions, pregnant women and parents caring for young children, access to an appropriate toilet is not just a convenience; it is essential. With the new EHRC guidance, those who are transgender, non-binary or do not conform to gender stereotypes—for whom the disabled loo is not their preferred choice, and nor should it be—now find that the disabled toilets may be the only way to protect their dignity and stay safe. Public toilets are becoming even more of an issue for more people.

There is also a widespread assumption that men’s toilets do not need sanitary bins, but they are essential for many men living with stomas. I was also delighted to join Matt Forde in Parliament last year as part of the prostate cancer “Boys Need Bins” campaign. For people with continence issues, the absence of bins can have a completely unnecessary effect on their confidence, dignity and independence. This includes people with stomas or bladder, bowel or digestive conditions.

Liberal Democrats are therefore calling on the Government to ensure that all public toilets are equipped with sanitary bins and to update workplace guidance to reflect the needs of men as well as women. There has been progress thanks to organisations such as Colostomy UK, as well as retailers such as Morrisons and B&Q, both of which made their toilets stoma-friendly, possibly after the experience the hon. Member for Fylde shared earlier. We want the Government to work with national retailers to ensure that accessible toilets are routinely made stoma-friendly. As some businesses have shown that it can be done, the challenge should be to make good practice the norm.

On access to toilets more widely, the British Toilet Association estimates that the number of public toilets has fallen by around 40% since the turn of the century. Its estimates suggest that only 4,000 public toilets remain in England—one public loo for every 14,000 people. We call them public conveniences, but they are in fact a public necessity. Their decline is happening as our population is ageing and more people need the confidence that facilities are available when they go out. If we want thriving high streets, vibrant parks and successful tourist destinations, we need decent public toilets.

The needs of other groups, including homeless people, refuse collectors, postal workers, delivery drivers, community nurses, social care staff, taxi drivers and highway maintenance crews, are also forgotten. I know that from personal experience, because about 10 years ago, I worked a full eight-hour shift alongside refuse collectors, starting at 5 am. When I climbed into the cab with my bottle of water and my can of Coke, they said, “You can’t drink; you can’t eat. There’s nowhere we can go.” I thought it was ridiculous that those people, who worked for us, had absolutely nowhere on their route where they could go. There was no way that we could go into a supermarket or a petrol station; we absolutely stank. It would not have been reasonable for us to go into a private business and expect to use its toilets. Thankfully, the local council addressed the issue with changes to its workplace facilities, but that sort of thing should concern us all.

The Government rightly speak about healthy ageing, thriving town centres and reducing inequalities, yet all those things become harder to achieve if people are not confident about finding a toilet. If the problem is so obvious, why has it continued to get worse? Part of the answer lies in the law. Currently, councils have a power to provide public toilets, but not a duty to do so. When budgets are stretched, discretionary services are often among the first things to disappear. I do not blame councils; I used to lead one, and I know that the system is so stretched and that few options are available when budgets are getting smaller and smaller.

I propose a change in approach, and I hope that the Minister and her colleagues will give it serious consideration. Councils should have a statutory duty to ensure sufficient public toilet provision within their area. That does not mean that every council must directly own or operate those facilities—community toilet schemes and partnerships with businesses, libraries, leisure centres, churches and town councils can all play an important role—but there should be a duty to assess local need, identify gaps in provision, and ensure that facilities are available when people need them and reflect a local population’s health profile. I am sure that the Minister will refer to the Pride in Place scheme, which is great for the areas that have it, but thousands of communities around the country will not have access to that capital. There needs to be a way for those areas to ensure that their residents are also protected.

The Liberal Democrats also believe that Governments must support local authorities to reverse the decline in public toilet provision. Councils cannot be expected to deliver improved services if they are being continually asked to do more with less. Alongside the duty should come expectations for accessibility, maintenance and cleanliness. A toilet that does not lock, or is filthy or unusable, is not really a toilet. Where facilities are built or refurbished, they should be genuinely inclusive, including by being stoma-friendly. We should also think carefully about signage. Not every disability is visible, and the current image of a wheelchair may itself drive the perception that someone is “not disabled enough.” The adjustments required are small, simple things: shelves, mirrors, hooks, disposal bins and signage.

This is a public health issue because people who choose not to go out will become more isolated, and that will affect their mental health. Those who restrict fluids to reduce the risk of getting caught short can develop other conditions. Those who are forced to change their stomas on filthy floors, or change their disabled child behind a bush, will not only face distress but risk serious infection.

[Mr Snowden]

The hon. Member touches on a point that I started but never finished in my walkthrough of life with a stoma, and it relates to children. I have a four-year-old. I have read the stories of parents trying to deal with children who are months old, not years old, and require stomas. As parents, we know what it is like managing a day out, but imagine trying to manage it for a child with a stoma. Imagine trying to give that child as normal an upbringing as possible. Unfortunately, the reality for that child is that they could face bullying and self-confidence issues from everything that goes with having a stoma. Those parents should be able to plan normal days out and provide normal lives for their children, so ensuring that schools and councils manage public toilets in a way that is friendly to people with stomas is important. I cannot feel anything other than real heartache for families who have to deal with that as they try to do their best by their child.

[Vikki Slade]

I thank the hon. Member for his intervention. I worked for Diverse Abilities, which looks after disabled children and adults in Dorset. The number of times that we could not ensure that the children in our care had suitable facilities was really frightening. I spoke at the Backbench Business Committee earlier this week, where the hon. Member for Bexleyheath and Crayford (Daniel Francis), put in a pitch for a debate on a new strategy for Changing Places toilets. That is hugely important, and I would absolutely support it.

[Jim Shannon]

Let me read out an example. I do not know this young lady, but you know her incredibly well, Mr Dowd. She is a young constituent called Jessica, who has had a stoma since she was four years old and has campaigned for 16 years. She fundraises to provide special teddy bears with their own stoma bags to children preparing for surgery. They are called Buttony bears. She works with Colostomy UK’s “Step Up for Stomas” campaign to promote an active and positive lifestyle. You are right to say that she is a heroine, Mr Dowd; she is a very brave young girl. She has her own Facebook page to raise awareness. We now know her story because you have shared it. We think of her, too.

--- Later in debate ---

[Vikki Slade]

I thank the hon. Member for his intervention on behalf of the Chair, and I pay tribute to Jessica—what a fantastic young lady! Her story, having gone through her childhood and teenage years with this condition, is incredibly heartwarming.

Wales already has the statutory requirement for a local toilet strategy. Surely England can do the same—it is not a flashy proposal. As we said earlier, it is about very basic needs. It does not require a new quango or a major reorganisation; it is simply about recognising that public toilets are part of the essential infrastructure of a modern and civilised society.

Whether someone is living with a stoma, raising a young family, managing a disability, working outdoors all day or simply getting older, access to a toilet should not determine whether they can take part in public life. The British Toilet Association’s “Legalise Loos” campaign talks about the “loo leash”, and states that

“14 million people have incontinence issues; 15 million people menstruate, and 16 million people have a disability.”

We are failing all those people if we do not have decent toilets.

My message is simple: support research into stoma-friendly facilities, work with retailers to make accessible toilets fit for purpose, ensure sanitary bins are available wherever they are needed, support councils to reverse the decades of decline in public toilet provision and make it a statutory responsibility to have a strategy. Alongside those measures, move from powers to duties by requiring councils to assess need, ensure sufficient provision and provide clean, accessible and dignified facilities. Public toilets are not an optional extra or a convenience; they are part of essential infrastructure. Until we recognise that fact, too many people will remain excluded from public life simply because they cannot be sure where they will go when nature calls.

--- Later in debate ---

[Nesil Caliskan]

I absolutely take the point. There is a conversation to be had with the sector, local authorities and the Local Government Association about how we can best support local authorities to do that. I think there is a real willingness among local authorities. I accept the point about statutory services, but there are great examples of local authorities providing services that are not statutory because they recognise the importance of public provision.

[Vikki Slade]

I take the Minister’s point. As a former council leader, I know that the last thing that councils need is a whole load of additional things that they have to do, but the point is that there is fear and inconsistency. If there is a postcode lottery when it comes to whether a council is sufficiently interested in ensuring provision or making information available to people, people will end up staying at home because they do not know what the rules are in the place they are travelling to. I gently urge the Minister to think carefully about placing a duty on local authorities to make provision in their area. If we want everybody to have the opportunity to engage in public life, that is the bare minimum.

[Nesil Caliskan]

I absolutely take the point, but there is scope for us to consider how to do that without putting additional statutory burdens on local authorities. Ultimately, we want the same outcome: we do not want a postcode lottery. A person who needs accessible toilets should know that they can leave the house and access them. I am open-minded about whether we do that through regulation or by having schemes that support the roll-out of better facilities. There are good examples of services being delivered across the country, so we should look at how the sector can learn from them and how the Government can best support local authorities.

Bins and toilets are areas of interest for local authorities, councillors and council leaders. I note the experience of Members in the Chamber who have a local government background. I recall rolling out a community toilet scheme when I was council leader. That required very small things, such as small grants to businesses—I think they were £1,000—to encourage them to make their facilities available to the public. That meant that the local authority did not have to think about additional toilet spaces. In many ways, the provision of a toilet in a local business or on a high street meant that our residents had more access than they would if they had to go to a park.

[Vikki Slade]

I cannot resist the opportunity to plug the fact that, prior to being the council leader, I had a business on Broadstone high street, and we were part of the community loo scheme. There are currently five or six businesses in my ward that have open access to their toilets. Previously, there was one public toilet, which was often closed, vandalised or subject to crime. I want to take the opportunity to tell the public that “use your loo” schemes are there for people; they do not need to buy anything. It is really important that we remind our residents of that, because people are often reluctant to go into a café if they are not going to spend money.

[Nesil Caliskan]

That is exactly the point that I am making. I thank the hon. Lady for highlighting that very good example of what local leadership can deliver in the community. It is important that we empower local authorities and leaders to think outside the box, champion this issue and speak up on tricky topics. That gives me the opportunity once again to pay tribute to hon. Members for taking part in this debate. By talking about and giving attention to a difficult subject, we are able to shift views and encourage our public sector to provide facilities that meet the needs of our communities.