The Jubilee Line used to be one of the better London Underground lines to travel on if, like me, you have Crohn’s disease. When the line was extended in the late 1990s, some of the new stations – Stratford, Canada Water, North Greenwich – were equipped with toilets, a great rarity on the Tube. They weren’t very nice, but if you’re liable to need the loo frequently and urgently when you’re out and about, it’s nice to know that you’re provided for. A couple of months ago, when the disease was in one of its ‘active’ periods, I was informed by my digestive system that I would need to get off the Tube early at Canada Water and use the facilities. It was now or never: I was about to change for the London Overground, an almost entirely toilet-free line. As I got out, I noticed a sign: ‘There are no public toilets at this station.’ There bloody well are, I thought. I’ve used them. I walked towards them as quickly as I could, hoping there would at least be a disabled cubicle I could open with my radar key. I found a disabled toilet but no hole for the radar key. Instead, there was a set of buttons – a combination lock. Lucky for me, on this occasion, the library opposite the station was open late, otherwise my only option would have been a dirty protest.
This, and similar experiences – not all of which have had such fortunate outcomes – have been part of my life since my early twenties, when I first became ill with Crohn’s. It has a variety of symptoms, of which the results of chronic bowel inflammation are the most persistent and embarrassing. Public toilets are a joke; in London they barely exist. It amuses me to imagine that there are people who actually take street signs pointing to a ‘Toilet’ seriously, a mistake I learned early on not to make. Most often there is no longer a toilet there, or it has been permanently closed. Instead I walk into the nearest pub and ask nicely, showing my official-looking Crohn’s & Colitis UK ‘Can’t Wait’ card.
But when the drugs stop working – which they usually do about a week before my eight-weekly intravenous dose of Infliximab, an anti-inflammatory medication – a better plan is needed. On one occasion they wore off four weeks early, at a time when I had a lot of travel planned. Living on soup and water, I used Google Maps to plot where the cafés and service stations would be on my journeys; looked up the facilities at every station on the Tyne and Wear Metro (toilets only at three interchanges with the bus network); and one night ended up helpless on the way home from my sister’s house in Catford at midnight, with the pubs closed and nowhere to go to the loo.
I’ve written about this from time to time before, but some people consider it to be ‘too much information’. ‘Readers don’t need to know this much about your bathroom needs,’ one editor told me. Perhaps not. But as the Canadian journalist Lezlie Lowe points out in No Place to Go, such needs aren’t unusual. One expert she quotes estimates that at least a quarter of the population regularly has a pressing need to use public toilets: ‘Seven per cent have paruresis. Another 7 per cent are incontinent. You’re already up to 14. You throw in menstruating women, parents with kids, people with ostomies … too many to count.’ Yet it’s a subject greeted with nervous giggles, or as something beneath talking about, much less making policy around. (‘Go behind a hedge,’ the campaigner Clara Greed was told by the manager of Paddington Station when she complained about the inaccessibility and inconvenience of their coin-operated ‘conveniences’.) Lowe draws a contrast with disabled access, where there has been firm legislation and widespread retrofitting of buildings and public spaces, at least in the countries she focuses on (the US, UK and Canada). Austerity, regeneration and re-urbanisation, automation, the ageing of the population: Lowe finds that all of these have direct and usually deleterious effects on whether or not you can find a public loo.
Lowe’s account begins with her own experience as a mother of young children trying to use a public toilet in Halifax, an affluent, well-planned city in Canada. Halifax Common is ‘a place built for leisure’, she writes. ‘Unless, that is, you’re the kind of person who uses the bathroom.’ The facilities are rudimentary, badly designed and frequently locked; entirely inadequate to the needs of their users: ‘Every time I’m out with my infant and toddler, I need to change a diaper or respond to the urinary urgency of my [children].’ In 2014 the municipal government in Halifax published a masterplan for its parks and open spaces without a single mention of toilets. Lowe lists the usual explanations for this: the cost of upkeep, the problem of vandalism and above all the fact that all sorts of people – drug users, say, looking for a place to inject, or homeless people wanting shelter, or gay men meeting for sex – may use a park’s toilets as well as middle-class mothers. ‘Providing bathrooms means welcoming the world,’ Lowe writes. But ‘keeping some out is most easily achieved by keeping everyone out.’
The book flits between historical accounts of the rise and fall of the public toilet and discussion of how the idea might be made to work in the present day. Lowe has much to say about the profound inequalities in the way toilets are designed, above all the fact that men’s and women’s toilets have the same dimensions, and are usually provided in equal numbers, even though women have quite different needs: it takes longer to pee, it takes longer to undress, and there are the additional requirements of menstruation (cubicles rarely include sinks, for instance). Lowe tells the story of pissing herself as a child ‘in the bathroom line at a community hall dance’, as ‘all the while, the boys’ bathroom door hung ajar, the light on, the room unoccupied. I could literally see the toilet. Not a single girl in that line made a move.’ The first flushing public toilets were installed at the Great Exhibition in 1851, but the first permanent public toilets for women weren’t installed until 1893 (on the Strand, if you’re wondering). Recently there has been some attempt at redress through the increased use of unisex toilet stalls. But, as Lowe points out, desegregated toilets create problems for those who adhere to Orthodox religious rules about the non-mixing of the sexes. The solution – cubicles for everyone – would however involve extensive, expensive refitting, when at present public toilets are barely provided at all.
Provision, not design, is Lowe’s principal concern. The decline in Britain has, she finds, been especially remarkable. In the US, there has only ever been a relatively rudimentary network of public toilets, so there wasn’t much of a legacy to destroy (with some exceptions, such as the New York subway, whose 1500 toilets have been reduced to 75 because of ‘security concerns’). In the UK, by contrast, every town has public toilets, often elaborately designed, dating from the late 19th century. Originally attended by permanent staff, these were an inextricable part of the ‘gas and water socialism’ of the era, along with libraries, sewers and schools. It was uneven and discriminatory, but it was something rather than nothing. Lowe cites a BBC report from 2016 revealing that a total of 1782 public toilets had been closed in the previous ten years. In London, half of all council-run public toilets have now closed. One consequence is that ‘some of London’s ornate underground Victorian-era facilities are being sold off and transformed into kicky little cafés and hip restaurants’ – if you’re polite and look reasonably clean and tidy, they may even let you use their loos. Like other campaigns to preserve aspects of the British welfare state, the various efforts to save council toilets ‘aren’t for better provision, but to keep what’s there now’. The incentive for councils struggling under austerity to sell up their toilets and the land they sit on is enormous. As one council worker told Lowe, you can sell a toilet for four or five million pounds, or you can spend half a million maintaining it.
One reason so many Victorian public toilets have been closed is the cost of providing disabled access, which, unlike the provision of public toilets, is now statutory. It’s expensive and fiddly to update a Victorian loo reached by steep iron steps, so it’s easier just to close it; the public loo is disappearing partly as the result of a conflict between different rights, or levels of rights, between the legally mandated and the merely advisory. Lowe refers to the ‘British Standards Institution’s Guide to Standardisation for public toilets’, a precise and detailed 54-page document whose excellent advice is undermined by the fact that, as its authors admit, ‘these best-practice standards aren’t universally implemented, because they are voluntary.’
Where public toilets have been installed in the last twenty years, they have tended to be of a particular sort: the automated kiosk, with advertising bolted on to cover the cost. You are allowed to occupy the cubicle only for a limited amount of time (to deter rough sleepers), and when you leave, they completely wash and dry themselves, obviating the need for a toilet attendant (or, more to the point, the need to pay their wages). The toilets seldom have seats, in case they get ripped out; soap and paper are often absent; and they are lit with UV lights, designed to make it hard for heroin users to find a vein – which, Lowe discovered, has the unintended side-effect of encouraging people to use the kiosks for sex. Apparently many people find the lights erotic. ‘When automated flushers and faucets and hand dryers stop working,’ Lowe writes, ‘no human is there to know except the users, who have, precisely as a result of automation, been alienated from the space and feel no need to go out of their way to report, for example, a non-flushing and rapidly filling clogged toilet.’
One or two American cities have noticed that these bleak, often vandalised coin-op kiosks aren’t good enough and have created alternatives. In San Francisco there’s the ‘Pit Stop’. These were set up in partnership with JCDecaux, which dominates the automated toilet market, as part of a cleaner streets initiative, and generate profit from waste via advertising revenue. They also provide various things that other toilets don’t – needle disposal units, and receptacles for compost, recycling, dog waste – but most important, they are staffed, albeit by ‘former state prisoners paid … $16 an hour’. The attendant maintains the queue, checks that only one person goes in at a time, and keeps the cubicle clean and stocked with toilet paper and soap. The introduction of the Pit Stop led to a massive rise in public toilet use in the city, not only by homeless people but also by tourists, families with children, and ‘other people with unconventional bathroom needs’, such as Uber drivers. The Pit Stops are profit-making; but the wholly municipal ‘Portland Loo’ in Oregon’s biggest city provides a similarly high-quality service.
Given the current pressure on local government funding in the UK, it’s hard to imagine councils paying for new kiosks, toilet attendants, or even to maintain their existing loos. Instead, people are encouraged to use the facilities in shopping centres, pubs and cafés. Manchester City Council, which has closed every single one of its loos in the city centre, has told people to ‘go and use Starbucks’. If only they’d been at the Starbucks I once tried to use in Nottingham, next to the railway station. For reasons best known to them, the staff locked the toilets at 6 p.m., some hours before the café itself was due to close. A local ‘character’ was hanging around, telling the people heading in the direction of the loos that they were now closed; he could probably have been gainfully employed to attend some functioning public toilets.
In any case, as Rudy Giuliani’s former deputy mayor Fran Reiter admits, ‘you know as well as I do that if some homeless person, some bag lady, walks into Tiffany’s, they are not going to let her use the toilet.’ Often, you will have to spend money in a place before the staff will give you the code or a key: ‘These toilets are for customer use only.’ Shopping centres tend to signpost their toilets in a deliberately oblique manner, intended to keep you endlessly circling past the shops. Lowe suggests that the free-to-all toilets in public libraries are a good alternative to the facilities in shops or cafés. She evidently hasn’t been told – as I was recently by a librarian at Chandler’s Ford Library, Eastleigh – that they didn’t have any toilets and I should use the ones in Waitrose instead.
Of course, they do have toilets. Every workplace that has a roof (and some that don’t, like building sites) in Britain and North America does, because, by law, they have to. That doesn’t mean, Can’t Wait card notwithstanding, that they have to let members of the public use them. I briefly had a job compiling traffic surveys on a busy junction in a London suburb. The inevitable happened early one morning, and I had to ask the places that were open – newsagents, the post office – if I could use their staff toilets, and was politely told in every case that I could not (I quit the job soon after). One of Lowe’s interviewees who has Crohn’s points out that although ‘people with physical disabilities – the ones others can see – have fought hard to have their accessibility needs met … and they’ve mostly won,’ those with diseases that don’t show have so far had much less success. This is changing, if slowly. ‘Not All Disabilities Are Visible’ signs can be seen on disabled toilets; Jeremy Corbyn wore a Crohn’s & Colitis UK badge at prime minister’s questions for ‘Crohn’s and Colitis awareness week’ last December. Yet there is no new policy. The nearest miss was in the Welsh Assembly, where the Public Health Bill drafted in 2014 by the then health minister (and now Welsh Labour leader), Mark Drakeford, included provisions to make it legally mandatory for the first time for all local authorities to have a ‘public toilet strategy’. The bill was defeated, largely because it also included strict restrictions on the smoking of e-cigarettes in public places, which antagonised Plaid Cymru, the Tories and the Lib Dems. It’s typical that the toilet policy wasn’t considered important enough to stand on its own, and was abandoned because of something completely unrelated to it.
Lowe moves towards a radical solution, which given the scale of the closures is increasingly the only feasible one. The key issue, if you have Crohn’s or colitis, isn’t what sort of toilet there is, but that you can use it, and immediately, whether or not it has glory holes, needles on the floor or a 50p charge. ‘Help for people with most diseases of the bowel comes not from design modifications, but by way of fast and easy access to bathrooms. Everywhere.’ It boils down, Lowe writes, to the following request: ‘Please, stranger, let me use your bathroom right now, because I really, really need it.’ Austerity has forced us to contemplate the previously unthinkable: the legally mandated public use of private toilets.
This isn’t as far-fetched as it might seem. As awareness of these conditions grows, the government is under increasing pressure to improve access to toilets in public places – and how much easier to shift the burden to the private sector (though as with the law requiring licensed premises to provide free drinking water, businesses may charge for the ‘service’). ‘During the night I have a dream in which I join a subversive organisation called the Socialist Lavatory League,’ Kenneth Tynan wrote in his diary in 1973. ‘Its purpose is to bring all private loos into public ownership. Everyone will have the right to use anyone else’s loo – which will mean the end of private peeing. The dream wakes me up giggling, but on consideration I don’t think it is all that bad an idea.’ There is some irony in the fact that it is thanks to the abandonment of any concession to one of the most basic human needs – unless it can be used to generate profit – that we can now imagine the utopian dream of the Socialist Lavatory League coming to pass.
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