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Report calls for more public toilets


public health issue, public toilets, recommendations, report, Royal Society for Public HealthThe inadequate provision of public loos is a threat to health, mobility and equality.

In recent decades increasing pressure on local authority budgets has led to the privatisation or closure of many public toilets.

In a YouGov UK survey in 2017, 59 per cent of women reported that they regularly queue for a toilet, compared with 11 per cent of men.

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, but 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.

And now a report just published by the Royal Society for Public Health (RSPH) has shed light on the health burden of declining public toilet provision, which falls disproportionately on people with ill health or disability, the elderly, women, outdoor workers, and the homeless.

The inadequate provision of public loos is a threat to health, mobility and equality, and it is time, the report concludes, that these services were considered as essential as streetlights and waste collection.

The report calls for:

1 – 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.

2 – Potty  Parity: Alongside this, ‘potty parity’ laws  – as exemplified in the US, Canada and elsewhere –  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.

3 – 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 underfunding: analysis by the Local Government Association showed that local services will face a funding gap of £3.9 billion by 2019/2020, rising to £7.8 billion by 2024/25.

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 short-sighted funding cuts, and properly resource local authorities.

4 – 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; or

Tax breaks for major donations to build or sustain a public toilet. • More advertising and optional purchases within public toilets or nearby.

5 – 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.

Shirley Cramer, Chief Executive, RSPH, said: “Our report highlights that the dwindling public toilet numbers in recent years is a threat to health, mobility, and equality that we cannot afford to ignore.

“As is so often the case in this country, it is a health burden that falls disproportionately on already disadvantaged groups.

“Standing in the way of this necessary and serious policy discussion is a stubbornly persistent ‘toilet taboo’, a decade of cuts to local authorities, and an increasingly ingrained notion that public toilets are merely a ‘nice-to-have’.

“Public toilets are no luxury: it’s high time we begin to see them as basic and essential parts of the community – just like pavements and street lights – that enable people to benefit from and engage with their surroundings.

“It is deeply concerning that amidst a national obesity crisis, at a time when public health policy is to encourage outdoor exercise, our declining public toilet provision is in fact encouraging more people to stay indoors.”

To read the full report, click here.

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