A lav affair: do we care enough about public toilets?

Deborah Fenney writing at The King’s Fund: When was the last time you used a public toilet? Not in a train station or a shopping centre bathroom – a local authority-maintained, public facility? For most of us, this is likely to be an increasingly rare event. Local authority spending on public toilets in England has declined by 50 per cent in the past 10 years and recent BBC analysis showed a significant drop in the number of public toilets across the UK.

While anyone can find themselves ‘caught short’, for some people this happens more than others. Women have more reasons and take longer to use a toilet than men, for example due to periods or pregnancy, and the lack of equality in toilet provision for women is well-recognised. For people living with bladder and bowel conditions, lack of facilities is a major concern. And if the toilet isn’t accessible then the impact is the same as no toilet at all. Transgender and gender non-conforming people, sometimes denied access or harassed in public toilets, may avoid them due to safety concerns. Additionally, disabled people frequently encounter inaccessible toilets, including those that are intended to be accessible. This is also about the infrastructure around the toilet, for example the signage and general accessibility of the building.

Toilet Signs

This issue is not yet getting the attention it deserves. Talking about toilets tends to provoke discomfort: for a variety of social and cultural reasons people are often reluctant to talk openly about toilets. But going to the loo is a universal human need, and the facilities available to us can have a significant impact on our health.

At an individual level, there are physical and mental health consequences when adequate public toilet facilities are not available. People report dealing with a lack of access to toilets by restricting fluid intake and ‘holding on’, leading to risk of dehydration, UTIs and potential kidney damage. For some disabled people, the lack of accessible toilets has led to otherwise preventable surgical interventions. There are also social impacts, where people are forced to plan ahead and restrict their outings to places they feel confident they will find a toilet. Others simply don’t go out, putting them at risk of social isolation.

A lack of adequate public toilets will therefore affect public health interventions that encourage people to go out and about locally, for example to increase physical activity and reduce obesity. Public toilets are a key part of our built environment and thus part of its impact as a wider determinant of health, an important feature of the places we live in, and having an influence on our health behaviours and lifestyles. It therefore makes sense that adequate public toilet facilities are part of efforts to improve population health.

In looking at this topic, I was struck by the number of organisations and campaigns calling for more and better public toilet provision, set against the steadily decreasing funding in local authorities. No one body holds overall responsibility for public toilets, and there is no compulsory provision in legislation. Campaigns have led to some additional national funding for Changing Places toilets (those with more space and equipment such as hoists) in sites such as motorway service stations and hospitals. With the exception of this, however, there appears to be very little activity on a national level from the relevant departments. There does not seem to be a coordinated approach to addressing the reduction in public toilet facilities across the country. This seems like a missed opportunity to address an issue with a significant health impact.

Many local authorities have looked for alternatives to publicly maintained facilities, for example, community toilet schemes where businesses make their toilets available for the public in return for a financial incentive from their local council. However, several researchers in this field have raised concerns that these schemes are not adequately accessible and do not meet the needs of a diverse population that includes people from different religious backgrounds, people of different ages and homeless people. There is a question of whether we need more toilets or more access to those that already exist – but there is little argument about the inadequacy of current provision.

All of this has prompted my interest in the role the health sector might have to play in supporting public toilet provision. I’m also keen to hear if the issues raised here reflect experiences of readers and I‘d be interested to know if there is anywhere public toilets are thriving. The Royal Society for Public Health is shortly releasing the findings of a survey that will give further insight into public toilet access across the UK. Researchers in urban planning and disability studies have created various guides for good practice in toilet provision. Ensuring public toilets are consistently on health agendas would seem to be a key part of ensuring decent access for all.

April Price Hikes: What You Need to Know

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Have you noticed that most of your everyday essential bills seem to be more expensive this month? That’s because the 1st April was named National Price Hike Day. Various industries such as energy, telecoms and the public sector were hit by inflation price rises totalling £4.5 billion. Sadly, for households, that means you could see £240 a year added to your bills across these sectors.

Why is this happening?

To cover the cost of inflation rates, businesses raise their prices. Ofgem, the energy regulator increased its price cap in response to the rise of wholesale energy costs. Sky, the TV and broadband provider, didn’t reveal why the prices were increasing. Mobile phone companies increase their bills each year in line with inflation. TV licences are set to rise each year until 2022.


What has increased and by how much?

Council Tax

Local councils around the country are increasing their council tax. The exact amount depends on your band and region but the average band D council tax bill will rise by £78 to £1,750 a year.

Energy Bills

With the cost of energy rising for companies, this has been passed on to customers by an average of £117 a year. The energy price cap is responsible for this – it was increased by Ofgem and will be reviewed again in October. All the big six energy companies (British Gas, E.ON, Scottish Power, EDF Energy, npower and SSE) raised their prices by 10% or more.

For standard tariffs – more than 50% of people are on these  – the price cap rose from £1,137 to £1,254 a year.

For fixed tariffs that are coming to an end, the average increase is £247 or £287 if your tariff is ending in May.

Water Bills

Water bills have been increased in line with the water regulator’s five-year plans. This year, they’re set to increase by as much as £16 a year or £8 for most households.

Mobile Phone Bills

All major networks (O2, Three, EE and Virgin Mobile) have announced price hikes in line with inflation.

For EE customers, there will be a 2.7% increase, so £9.72 a year for someone on a £30 monthly contract.

For O2 and Three customers on a pay monthly contract, this will be £9 a year based on a £30 contract.

Sky TV and Broadband

How much your Sky bill will increase depends on what sort of package you have. Most customers will see an increase of £3.50 a month.

  • Broadband – £1 a month increase
  • Fibre broadband – £2 a month increase
  • Sky Entertainment – £2 a month increase
  • Sky Multiscreen – £1 a month increase
  • Sky Ultimate on Demand – £2 a month increase
  • Sky Cinema – £1 a month increase
  • Sky Phone (Talk Anytime) – £2 a month increase
  • Sky Phone (Talk Evenings & Weekends) – £1 a month increase


Stamps will rise by 3p. The price of a first-class stamp for a standard letter will rise to 70p, whilst a second-class stamp for a standard letter will increase to 61p.

NHS prescriptions

NHS prescriptions will increase by 20p from £8.80 to £9.

Car Tax

The amount of extra car tax you’ll pay depends on the amount of emissions that your car produces:

  • 76g/km-150g/km of CO2 – Extra £5
  • 151g/km-170g/km – Extra £15
  • 171g/km-190g/km – Extra £25
  • 191g/km-225g/km – Extra £40
  • 226g/km-255g/km – Extra £55

Diesel cars which don’t meet the standard for nitrogen oxide emissions will have to pay a higher rate of tax, potentially up to an extra £500. Cars that are more than 40 years old, or registered between March 2001-2017 with emissions of less than 100g/km are exempt from Car Tax, as are vehicles with zero emissions.

You can find out your car’s emissions by visiting the Gov.UK website.

State Pension

Those who pay into a state pension will see their contributions increase from 3% to 5%. For instance, someone who earns around £27,000 will see their contributions rise from £500 to £850.

How to manage your household budget

Now is the best time to get your budget together for the year ahead. Here are the Money Advice Service’s top tips:

  • Consider switching energy supplier, especially if you are on a standard tariff which is often much more expensive than other options.
  • Use a budgeting planner tool such as the one from the Money Advice Service to map out your finances. If you’re on Universal Credit, try the Money Manager tool.
  • Cut down any expenses that you don’t need – could your swap your phone contract to a SIM-only tariff? Or downsize your Sky subscription?
  • If your car is due to be changed, swap to one with lower emissions. Better still, if it’s practical, get rid of the car completely!
  • Look at getting a prepaid prescription certificate if you regularly need to collect medicine
  • Use the Turn2us Benefits Calculator to see if you’re entitled to any welfare benefits which could help.

Although the price hikes may seem minor on their own, when you put them together they can take a big chunk out of your household finances. However, you don’t have to struggle with them – if things are getting difficult and you need someone to talk to, use the Turn2us Find an Adviser tool to find a local advisor who can help you. If you’re concerned about the effect of the price rises on your mental wellbeing, see free advice from the Money Advice Service website.

Source and thanks to: Liam Evans at Turn2us