Stoma: Public Toilet Provision
House of Commons · Westminster Hall · 18 Jun 2026 · 28 speeches · Official Report
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...
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.
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.
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?
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...
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?
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...
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...
I call the Liberal Democrat spokesperson.
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...
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.
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.
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.
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...
It is a pleasure to serve under your chairmanship, Mr Dowd-I wish you a happy birthday. I welcome the Minister to her place. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on the provision of public toilets for people living with stomas, which is too often overlooked and too rarely spoken about. He began by saying that although this is not a fashionable debate, the issue needs to be aired, and he was absolutely right about that. He was also right to say that this issue is about dignity and independence, as Members from across the House have said. This debate is important for many people throughout the UK-that is evident from the personal stories that have been shared by hon. Members. My hon. Friend the Member for Fylde (Mr Snowden) described the importance of humour to deal emotionally with this difficult and embarrassing condition, including by naming stomas, which is new to me-I did not know that was a thing; every day is a school day. I have to say that my favourite from his catalogue was also Vladimir Poopin, but maybe that reflects our politics more than anything else. I thank all hon. Members for their thoughtful contributions throughout the debate, particularly in highlighting the human reality of living with a stoma. Around 200,000 people in the UK live with a stoma following surgery for bowel cancer, Crohn’s disease, ulcerative colitis, diverticulitis and many other conditions. I do hope that I have pronounced those...
It is a pleasure to serve under your chairmanship, Mr Dowd. I begin by paying tribute to Members from across the House for the incredibly thoughtful and personal stories that they have shared. I am very conscious that Members speak on behalf of their constituents, and that some Members speak from personal experience. Although I do not have that personal experience, I have a very close family member who does, and I have heard Members speak in the Chamber before about their own experiences and have reflected very carefully on the power of those remarks for those beyond the House who hear them. I thank Members very much for their contributions. I also thank the hon. Member for Strangford (Jim Shannon) for securing this very important debate, and for his continued interest in this issue. I know that he is a committed advocate for public toilet provision, including for those with non-visible disabilities such as stoma use. I recognise the importance of the provision of good-quality, accessible public toilets more broadly. For far too many people, access to clean and safe public toilets can be the deciding factor in whether they feel able to visit a town centre, a high street, a park or any local attraction. As others put it so eloquently, such facilities support the dignity and independence of people with disability and accessibility needs. Of course, accessibility to a decent facility encourages everybody to spend more time in their local areas, and to use the shops, services...
Having been a councillor and served on the front bench of a council, I know about delivering these facilities, and I feel for councils when it comes to doing so. As has been said, the reality is that even if councils want to do their best, and they know what is best for their local areas, funding is tight. We all know that ever-increasing adult social care bills and so on are creating bigger burdens on local government finances, and statutory requirements will always take priority over other things. I do not want to create a system that ends up costing more than opening the toilets themselves through its complexity and bureaucracy, but it is really important to place some greater requirement on councils to understand the provision and fill the gaps. If the Minister is looking for a commissioner for the crappers in the future, it may be a role for me!
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.
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.
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.
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.
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.
The role of councils is incredibly important. The Government’s 10-year health plan sets out a shift from hospital to community, from sickness to prevention and from analogue to digital. For stoma care, moving from analogue to digital could mean remote monitoring for high-risk people living with a stoma, app-based ordering of stoma appliances, reducing prescription errors and delays, and digital self-management for diet, hydration and troubleshooting. Those are all critical issues for the health service to consider when moving from analogue to digital. I ask the Minister, whether or not it is in the notes I gave her, to look at that point as well. I also ask that she meets Colostomy UK with all Members present. That organisation has much more knowledge than me, and we look forward to that opportunity.
Absolutely. I am very happy to meet any campaigning organisation to discuss this important issue. I note that other hon. Members have also made that request. If charities would like to contact me, I will happily meet them to talk about how we can better support the needs of all our communities. On the important point the hon. Gentleman makes about the NHS plan and healthcare support, he is absolutely right. It is all the more reason why we need a joined-up approach to what local authorities and NHS local boards are doing. I take the opportunity to highlight health and wellbeing boards across the country, which will play a really important role in making sure that, as one part of the local authority is delivering something, it is making the most of what it is doing so that it meets the objectives of a different part. In the case we are talking about, health is a really obvious example. To return to my general point about local authorities thinking outside the box and doing things differently, one area we should encourage them to consider is how they conduct procurement. There are many examples across the country where public toilets in parks and open spaces have fallen into disrepair. Some local authorities are addressing that through procurement processes by stipulating, for example, that the owner of a new café must look after the toilets in that space. Those are good ideas that should be encouraged and will ultimately make it easier for our communities to access facilities.
The Minister is being incredibly generous with her time. She probably entered this room and, having seen only one Back-Bench Member, thought this debate would not get close to 4.30 pm-but here we are. I have two points. First, is there a greater role for section 106 moneys, potentially through planning processes, in supporting public toilets? The Minister gave a really good example of creative thinking around ownership of toilets in parks and cafés. My sister will kill me for saying this, but when she was growing up she had a phobia of metal toilets. I think it was actually just a phobia of unclean spaces. A lot of people would rather use a well-kept toilet in a private business, where they will not be judged for using it-provided it is not at the far end and they do not have to walk past all the tables with everyone looking at them-than use a public toilet that, by its nature and because it is not in a manned location, cannot always be guaranteed to be as clean. I think that is a great example. Will the Minister work with colleagues in local government to see whether that can be rolled out more, and consider how section 106 moneys might help to create more of an incentive for commercial operators who might not otherwise be able to afford it, or for whom it might not be viable?
I welcome the hon. Gentleman’s contribution. Section 106 moneys are often thought about in terms of big infrastructure money, but for a very small amount of money we can make a big public impact; the grant funding of £1,000 to a business is a good example of that. I am very happy to take that back. There are lots of examples across the country of where this is being done well, and we should, as a Government-I will take this back-find a better way to communicate some of that best practice. I also want to comment on the very important point the hon. Gentleman makes about lived experience. Too often, Governments and councils design and deliver schemes with good intentions, but they do not necessarily meet the real needs of communities. That is why lived experience must be at the heart of policymaking. He referenced his sister’s experience, and I will join him: my sister’s experience is not dissimilar. As he said, many people who live with such conditions develop great resilience over their lifetime. My sister, too, is incredibly resilient, because of her experience of living with her colitis, which was diagnosed as a teenager, as it is for many people. It is a very particular experience to be diagnosed with a lifelong condition as a teenager. People who experience that are some of the most resilient individuals in our community, and their lived experience is central to making sure that our councils and the Government design provision and services that meet their needs. In that...
I thank everyone for their participation, and those in the Gallery who gave us information to use in the debate. The hon. Member for Fylde (Mr Snowden) brought a focus to this issue in a way that I would have been too hesitant to do. I am too much of a traditionalist, too much of a conservative and maybe a wee bit careful, but I thank him for that. We need a bit of humour sometimes; he gave us that, and I thank him for it. I was fearful of what the next name he would come up with was going to be. I was sitting here thinking, “Don’t say that!” but that is by the by. Toilet provision must be clean. The psychological adjustment is something that we need to focus on as well. I just know how I feel and think, and if I had such a condition, I know how much worse it would be to try to deal with it. We must also focus on the knock-on effect on the NHS. The Minister has grasped that issue. The hon. Member for Harrogate and Knaresborough (Tom Gordon) always makes very perceptive interventions. He is no longer present, but in his absence, I thank him for his interventions on toilet provision and living with a stoma bag. The hon. Member for Mid Dorset and North Poole (Vikki Slade) has great knowledge of this matter. She has been active on this subject for some time, especially since she was elected but even before that when she was on the council. It would cost a small amount to address this issue, but it would have a big return. It is a bit like a credit union; if we invest a wee bit,...
Sitting adjourned.