Stoma: Public Toilet Provision

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.

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.

Among the things I have picked up on is what you call a stoma once you have one. The names are quite creative, and the naming process is, first, quite humorous and, secondly, about a degree of taking ownership of it. I will run hon. Members through some of the names that people come up with for stomas, so that we get beyond just a “surgical opening”. Some are ones that I have seen in research, and some are from people I know who have a stoma. Most of the names are a play on words, such as a rhyme with stoma, or references to poo or pumping—apologies to Members in advance, but hopefully there will find something in this for one of you.

As an opening gambit, there is Paloma Faith, which is a good name for a stoma. Winnie the Pooh is another one. Another favourite of mine is Vladimir Pooping, just because it takes the mick out of a dictator. To take something straightforward and simple, there is Windbag, which is pretty much what we are talking about. Captain Craptastic is another good one. Others include Donald Trumps and Bilbo Baggins. Finally, my favourite is Louis Shitton, which I think is excellent—I am delighted to have got that into Hansard. I hope that that gives a bit of insight. People who have had to have a stoma because of their suffering have been through difficult times, but they are remarkably resilient people, many of them with a great sense of humour.

Every Member in this House will have a constituent who has inflammatory bowel disease, colonic cancer or another of the conditions that leads to a stoma, and we will all have constituents with stomas—that is beyond doubt. Many conditions can lead to people requiring a stoma, although that will depend on how controllable a condition is in any individual person—whether they get Crohn’s or colitis flare-ups or whether the cancer is caught and treated early enough. Given all those things with a similarity of issues, Members will have hundreds, if not thousands, of constituents who have a stoma or who know someone directly affected.

The conditions themselves are embarrassing. It is not just about having a stoma, when you have got to that point; by the time you get to having one, you have usually been through years of having to deal with a condition and having to suffer it in silence, because you do not want to talk about it. There is also a lot of misunderstanding; a lot of people think that Crohn’s and colitis, for example, are some form of irritable bowel syndrome. Even well-meaning people suggest eating less spicy food or not eating brown bread, because they do not realise that the condition generates internal ulcers in the most painful place they could possibly be, and that those bleed internally, creating internal blood clots that need to pass through your system urgently, in an incredibly painful way—whether you had a Madras on Friday night makes absolutely no difference to that condition.