Stoma: Public Toilet Provision

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 thousands of people every single day. This debate is not just about public toilets for those with stomas. At its heart, it is about dignity, independence and inclusion. Those are the three themes that I wish to put on the record.

I apologise for not saying at the beginning that it is lovely to see the Minister in her place. I understand that this is her first debate, and I wish her well in her new role. We will not be hard on her—that is not in my nature—but we will collectively put forward a case, and she will respond in a positive way to encourage us on what we are asking for. I have four asks for her to look at.

For most of us, access to a toilet is something we take completely for granted. We leave home to go to work, visit friends, attend events, go shopping and go travelling without giving it so much as a second thought, because there will always be a toilet. That reminds me of a story. When I was in the armed forces parliamentary scheme, John Spellar, who used to be a Member, told me that he had two pieces of advice when we went on a course—he always gave good advice. He said, “If you see a toilet, go, and if you see food, eat.” Those were the two things he told me to do whenever I went anywhere, and I have always remembered his words of wisdom. The fact of the matter is that I did not have a stoma, so I could go to the toilet anywhere, but it becomes a great problem for those who have a stoma.

We assume that if we need a toilet, one will be available, but the many people living with a stoma do not have that certainty. That is the key theme of this debate. For the benefit of those following, a stoma is a surgically created opening in the abdomen that allows waste to leave the body into an external pouch. People may require a stoma following bowel cancer, Crohn’s disease, ulcerative colitis, diverticulitis, trauma or other serious health conditions. I have had a couple of friends over the years with Crohn’s disease and one with colitis. For a short period of their life they had a stoma, which helped them to heal and eventually they were able to do without it.

For many people, a stoma is lifesaving surgery that allows them to have a comparatively normal life. It enables them to regain their health, maintain their independence and continue living active and fulfilling lives. Having a stoma should not mean they cannot do that; it just means they have to deal with the toilet issue.

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 make the situation better. We talk about encouraging people to remain active in their communities and ensuring that those living with long term health conditions are not left behind, yet, as the hon. Member for Harrogate and Knaresborough (Tom Gordon) said, inadequate toilet provision can be a significant barrier to those ambitions, affecting the way a person plans their day, their journey or their outing.

If someone cannot be confident that they will find a suitable toilet when they need to, they may begin to avoid situations that others take for granted. They may stop attending social events, going to family occasions, travelling or visiting friends and family, or they may avoid shopping centres, cultural events or community activities. “If I go there and am caught short, where do I go? Is there provision? How far can I travel?” It is not that they lack the desire to participate, but that they are concerned about the predicament they might find themselves in because they lack confidence that the facilities they need will be available.

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.

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 because they cannot access a suitable toilet when they need one. I therefore hope the Government will consider how local authorities can be supported to ensure that people living with stomas and other long term health conditions are not disadvantaged by a lack of public toilet provision. I also hope the Minister will consider whether the current discretionary approach to public toilet provision is sufficient for those who rely on these facilities to participate in everyday life.

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.

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 involve—let us be honest—talking about poo, and the British public are not particularly comfortable talking about. So although the hon. Member for Strangford has outlined what a stoma is, most people are embarrassed about them. As I said, one way people get around that is by having a sense of humour. I have met many people with stomas; a very close loved one has a stoma, and I have met many of the friends she has made over the years during her many hospital stays.

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 Poo is another one. Another favourite of mine is Vladimir Poopin, 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.

Toilet provision is so important for people with stomas as well as those with the conditions mentioned. That is important to remember, because we can look at the number of people with stomas—Colostomy UK has provided a helpful briefing ahead of this debate—but that would give you a very distorted view about the total number who require access to toilets due to health conditions.

As other hon. Members pointed out, when someone who has a stoma goes to the toilet, they are either going to empty it or change it. Changing it is not a quick thing and if there is a leak, which is something anybody with a stoma lives in absolute fear of, that needs to be urgently dealt with. Visualise where that would be on your body. Even if just emptying it, the proximity to the toilet means also getting very close to the floor and the toilet itself. People suddenly become experts in the cleanliness of toilets and which companies keep clean toilets and which do not. It goes back to remembering the human in all of this, and not just taking it from a purely clinical and public health perspective.

Imagine going through years of dealing with a health condition that leads to needing major surgery that is life changing and life threatening in its own right and results in a stoma. Regardless of your age, but especially for younger people in this hyper body conscious world, that is not something that you want—it is not something that you are proud of—and it is something that you are often embarrassed about and will try and conceal and hide. Imagine having been through all of that and having recovered and just about psychologically coming to terms with having a stoma—and you want to go out. You want to pick up the courage to go out. You find some clothes that for the first time you think cover it so you do not feel self conscious about it. You go out, you feel sexy, you feel confident. It is a big boost. Then you either need to empty the bag or have the dreaded leak, and there is nowhere to do anything about it.

As one of my friends—I apologise in advance, Chair, but I am quoting—said: “Imagine getting dressed up for date night and then having to go and crawl around on a piss covered floor simply to change your bag.”

Would that do anything other than knock your confidence, dignity and self respect? It is not fair.

There seems to be a general consensus among forums and things I have read that we men need to have a little more care and attention in toilets than women do and that the standard in male toilets is often significantly lower. However, it is a point none the less. That is what I want to get across in this debate; I do not want to talk about the stats, figures and percentages. Every one of those numbers has a human being behind it who is trying to get on and rebuild their life under immense physical, psychological and emotional damage. That is what makes this so important.

There are also other issues including access to private toilets. All of this cannot fall to local councils. I have been working and campaigning on this since I was elected as a county councillor in 2017. I moved a motion in full council—those were the days—around access and the card that people can carry that says they need access to the private toilets in a commercial facility.

We have our own experiences of that in our family. These are pre stoma but they highlight the conditions as well. When shopping you suddenly feel the urge to go, and, as we have already established, you are not having a poo or a pump but are passing blood clots in an incredibly painful way and your body is trying to get them out of your system and you cannot contain it, and poo will come out with them. You are shopping and have decided to go out—even though, as hon. Members have already highlighted, a lot of people plan their journeys around that—you show your card to a member of staff and they point blank refuse to let you use the private toilets. You soil yourself in the middle of the shop, and then you do not go out for a long time afterwards because of the embarrassment.

I do not want to name or shame any individual companies that may have been involved in that example, but if I say that their slogan is “You can do it if you…it”, Members can draw their own conclusions. That chain was horrific. From my lobbying, I believe it has got an awful lot better of late. It is about raising understanding in organisations of what the cards are and why people carry them. That goes back to stigma and the “Not every disability is visible” campaign, which I pushed to be rolled out across Lancashire all those years ago. These conditions are not visible. Someone may look physically well but experience that urgency. We must make sure that people with stomas, advanced Crohn’s, colitis and so on know that they can get a RADAR key.

People need to know where the toilets are. Lots of different people have tried this in lots of different ways. We already accept that councils cannot be responsible for providing a toilet in all places at all times. If someone is going to go out and they are dependent on toilets being nearby, they need to know that there is a network of companies and commercial organisations that will let them use their toilets, even if there are not a lot. It is just about pubs and hotels knowing that sometimes, someone may need to come in. I know it is really annoying when non paying customers come in and use the toilets, but having those apps is important so that people can plan their days out and their journeys with confidence.

There are knock on benefits to the NHS and public health of helping people to have and maintain normal lives post traumatic bowel surgery and helping them with the psychological recovery. If they had to quit work, that could help them to get back into work. Stomas can be noisy. They rumble and pump. They are bowels, just on the outside of the body, or moving to the outside of the body. Dealing with that is hard enough. Therefore, people may not wish to empty or change a bag at work. They may wish to go somewhere near work to do it. They may work on the tools, in an outdoors job where they do not have routine access to toilets.

There are knock on benefits to the Government and to the Treasury of helping people back into work, stopping people becoming ill with mental health issues from lack of confidence and emotional damage, and helping people to manage their condition better so that they are not continuously spiralling and going back into the NHS. It is not just about doing the right thing and the moral obligation to those people.

The hon. Member for Strangford has already outlined Colostomy UK’s requests for things that could be advanced through building regulations to make toilets more stoma friendly and the general need for more public toilet provision. I am sure it will continue to lobby effectively on that. A lot of the time, this is about the role the Government can play in creating awareness among public bodies and organisations about why this is important—the human element that I have tried to outline. This is about people’s lives and the quality of life of some of people who deserve our support the most. It is about simple things, such as making sure that councils have nice, clean toilets, that toilets are open and that people can access information about where public and IBD friendly toilets are.

I am about to start repeating myself, so I shall end my speech, which is probably a personal best for inappropriate Hansard contributions—I look forward to reading them back. Once again, I thank the hon. Member for Strangford for securing this debate. This really is an important topic, and I know the debate will mean a lot to people. As I said, a lot of people with these conditions do not want to talk about it. They want to hide it. They suffer in silence. Their voice will not be heard. They will not contact their MP to ask if they can have better public toilets as they have a stoma or IBD, because they do not want people to know. It is therefore really important that we, as their elected representatives, are their voice. I hope that we can be their voice today, and I look forward to what the Minister and shadow Minister, my hon. Friend the Member for Mid Bedfordshire (Blake Stephenson), have to say.

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 want to enjoy those experiences, along with the rest of the family, but they feel trapped close to home and close to the facilities they know they can rely on.

Following the hon. Member for Fylde, I will have to ask my family member what they call their stoma. Given the prevalence of bad jokes that emanate from their home on a daily basis, I am sure they will come up with something. I may need to catch the hon. Member in the Tea Room and let you know what they come up with. Simple changes, such as shelves, mirrors, disposal bins, hooks and space to manage the stoma with dignity, can cost such a small amount but make such an enormous difference.

That is why the Liberal Democrats are calling on the Government to support further research into the adjustments that could promote the dignity, comfort and independence of people living with stomas. I would be interested to hear the Minister’s views about potential changes to part M building regulations, as suggested by the hon. Member for Strangford. Too often, these small facilities are absent or even removed for fear that they might be misused for other purposes.

It is shocking that more than a third of stoma users report being challenged or criticised for using accessible toilets because their condition is invisible. Two thirds of all disabled toilet users have experienced disapproving looks and almost half have been verbally challenged. Imagine how distressing it must be, particularly for someone recently diagnosed with a life changing condition who might already be worried about getting to a toilet on time, to face the judgment of strangers.

For people with stomas, older people, those managing disabilities or continence conditions, pregnant women and parents caring for young children, access to an appropriate toilet is not just a convenience; it is essential. With the new EHRC guidance, those who are transgender, non binary or do not conform to gender stereotypes—for whom the disabled loo is not their preferred choice, and nor should it be—now find that the disabled toilets may be the only way to protect their dignity and stay safe. Public toilets are becoming even more of an issue for more people.

There is also a widespread assumption that men’s toilets do not need sanitary bins, but they are essential for many men living with stomas. I was also delighted to join Matt Forde in Parliament last year as part of the prostate cancer “Boys Need Bins” campaign. For people with continence issues, the absence of bins can have a completely unnecessary effect on their confidence, dignity and independence. This includes people with stomas or bladder, bowel or digestive conditions.

Liberal Democrats are therefore calling on the Government to ensure that all public toilets are equipped with sanitary bins and to update workplace guidance to reflect the needs of men as well as women. There has been progress thanks to organisations such as Colostomy UK, as well as retailers such as Morrisons and B&Q, both of which made their toilets stoma friendly, possibly after the experience the hon. Member for Fylde shared earlier. We want the Government to work with national retailers to ensure that accessible toilets are routinely made stoma friendly. As some businesses have shown that it can be done, the challenge should be to make good practice the norm.

On access to toilets more widely, the British Toilet Association estimates that the number of public toilets has fallen by around 40% since the turn of the century. Its estimates suggest that only 4,000 public toilets remain in England—one public loo for every 14,000 people. We call them public conveniences, but they are in fact a public necessity. Their decline is happening as our population is ageing and more people need the confidence that facilities are available when they go out. If we want thriving high streets, vibrant parks and successful tourist destinations, we need decent public toilets.

The needs of other groups, including homeless people, refuse collectors, postal workers, delivery drivers, community nurses, social care staff, taxi drivers and highway maintenance crews, are also forgotten. I know that from personal experience, because about 10 years ago, I worked a full eight hour shift alongside refuse collectors, starting at 5 am. When I climbed into the cab with my bottle of water and my can of Coke, they said, “You can’t drink; you can’t eat. There’s nowhere we can go.” I thought it was ridiculous that those people, who worked for us, had absolutely nowhere on their route where they could go. There was no way that we could go into a supermarket or a petrol station; we absolutely stank. It would not have been reasonable for us to go into a private business and expect to use its toilets. Thankfully, the local council addressed the issue with changes to its workplace facilities, but that sort of thing should concern us all.

The Government rightly speak about healthy ageing, thriving town centres and reducing inequalities, yet all those things become harder to achieve if people are not confident about finding a toilet. If the problem is so obvious, why has it continued to get worse? Part of the answer lies in the law. Currently, councils have a power to provide public toilets, but not a duty to do so. When budgets are stretched, discretionary services are often among the first things to disappear. I do not blame councils; I used to lead one, and I know that the system is so stretched and that few options are available when budgets are getting smaller and smaller.

I propose a change in approach, and I hope that the Minister and her colleagues will give it serious consideration. Councils should have a statutory duty to ensure sufficient public toilet provision within their area. That does not mean that every council must directly own or operate those facilities—community toilet schemes and partnerships with businesses, libraries, leisure centres, churches and town councils can all play an important role—but there should be a duty to assess local need, identify gaps in provision, and ensure that facilities are available when people need them and reflect a local population’s health profile. I am sure that the Minister will refer to the Pride in Place scheme, which is great for the areas that have it, but thousands of communities around the country will not have access to that capital. There needs to be a way for those areas to ensure that their residents are also protected.

The Liberal Democrats also believe that Governments must support local authorities to reverse the decline in public toilet provision. Councils cannot be expected to deliver improved services if they are being continually asked to do more with less. Alongside the duty should come expectations for accessibility, maintenance and cleanliness. A toilet that does not lock, or is filthy or unusable, is not really a toilet. Where facilities are built or refurbished, they should be genuinely inclusive, including by being stoma friendly. We should also think carefully about signage. Not every disability is visible, and the current image of a wheelchair may itself drive the perception that someone is “not disabled enough.” The adjustments required are small, simple things: shelves, mirrors, hooks, disposal bins and signage.

This is a public health issue because people who choose not to go out will become more isolated, and that will affect their mental health. Those who restrict fluids to reduce the risk of getting caught short can develop other conditions. Those who are forced to change their stomas on filthy floors, or change their disabled child behind a bush, will not only face distress but risk serious infection.

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 duties by requiring councils to assess need, ensure sufficient provision and provide clean, accessible and dignified facilities. Public toilets are not an optional extra or a convenience; they are part of essential infrastructure. Until we recognise that fact, too many people will remain excluded from public life simply because they cannot be sure where they will go when nature calls.

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 correctly—there is a reason I am not a medic. On average, in a constituency such as Mid Bedfordshire, around 200 to 250 people are likely to be living with a stoma. With an ageing population and increasing diagnoses of bowel conditions, this need will grow, not diminish, over time.

For those people, a toilet is not a convenience but a necessity, as the Liberal Democrat spokesperson, the hon. Member for Mid Dorset and North Poole (Vikki Slade), said. A stoma bag must be emptied or changed at the moment it is needed. There is quite literally no waiting when it is required. Yet the facilities that most people with a stoma rely on—standard accessible toilets—are frequently not fit for purpose, as my hon. Friend the Member for Fylde eloquently described. Too often, there is no shelf on which to lay out medical supplies, no hook for clothing or a bag, no mirror to help someone change safely, no basin within reach and nowhere hygienic to dispose of used products. I thank the Liberal Democrat spokesperson for highlighting the “Boys Need Bins” campaign, which is an absolutely fantastic campaign that we should all get behind.

At present, provision depends on good will rather than on standards, which leaves a postcode lottery for something as basic as using a toilet. The result is people changing stoma bags balanced on their knees or on dirty floors. Someone with a stoma often must plan their entire day around whether a usable toilet exists. I come from a rural constituency and acknowledge what a challenge that must be on days out in the countryside.

There is a second barrier, which is one of attitude. A stoma is, in the main, an invisible disability, as hon. Members have said. Many people with a stoma or inflammatory bowel disease report being challenged or even abused for using an accessible toilet, or accused of being “not disabled enough” because they do not use a wheelchair. Simple signage and staff awareness can prevent the confrontations that many people with invisible conditions face. Those attitudes are a stain on us, and it is precisely why Crohn’s & Colitis UK’s “Not every disability is visible” campaign and Colostomy UK’s Stoma Aware work matter so much.

I am proud that the last Conservative Government understood that dignity in this area is a duty of the state, not an optional extra. When he was Local Government Minister, the former Prime Minister, my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak), led the drive to expand Changing Places toilets, with larger facilities with benches, hoists and space for carers, which the most severely disabled people need. He set in motion the change to building regulations that, from 2021, made Changing Places mandatory in large new public buildings in England, including shopping centres, stadiums and arts venues. That was backed by a £2 million fund to install them in more than 100 NHS hospitals, further investment in motorway service stations and funding for a national online map so that families could find them more easily. The public sector could lead by example across councils, hospitals and transport networks.

The number of Changing Places has risen from 140 in 2007 to around 1,200. That is a record of practical, compassionate action and I pay tribute to the programme, but—I say this candidly—Changing Places, vital as they are, are designed for the most profoundly disabled. Most people with a stoma are fully mobile. The solutions that they need are cheaper: the simple stoma friendly standard of a shelf, a hook, a mirror and a bin in ordinary accessible toilets. Some retailers—B&Q was mentioned, but I am sure there are others—have shown that it can be done across an entire estate at a modest cost. The additions required often cost less than a few hundred pounds per facility. This is not major capital infrastructure work; it is a small retrofit that has a huge impact on people’s dignity. The building blocks exist; what is missing is national leadership to join them up.

When people cannot rely on basic facilities, they withdraw —from work, from shopping and from social life. That is not just a personal loss; there are wider economic impacts, too. Constituents in Mid Bedfordshire have told me that living with these life changing conditions can be exhausting, isolating and unpredictable. The hidden nature of their symptoms means that they are often invisible to other people, but they deeply impact the daily lives of the people who have them. It is an honour to represent those people at the Opposition Dispatch Box in such a good debate, in which there is cross party consensus.

I would be grateful if the Minister could address three points. First, what are the Government considering doing to make places more stoma friendly? Secondly, what meetings have Ministers had with Colostomy UK and Crohn’s & Colitis UK to discuss options? Thirdly, what consideration are the Government giving to local government facilities, recognising the interesting proposal from the Lib Dem spokesperson, the hon. Member for Mid Dorset and North Poole, for a statutory duty?

This is not a party political issue; it is about whether someone can leave their home with confidence. The previous Government opened the door with Changing Places. I urge this Government to walk through it, finish the job and support people with stomas.

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 and attractions in them. I do not need to detail the benefits of that in itself.

It is true that for many people, it is just too difficult to access the facilities that the rest of us can access so easily every day. Members have correctly pointed out that that is a challenge not only for those with a stoma, but for many other people, including those with ulcerative colitis or irritable bowel disease. The list is much longer than that; the point is that many people are impacted by the lack of accessibility facilities.

However, this debate is focused on stomas, and I want to place on the record the Government’s recognition that this is absolutely a real challenge. Approximately one in 335 people of all ages in the UK is estimated to be living with a stoma, and each year more than 13,000 people in the UK undergo stoma surgery. For people living with a stoma, access to suitable toilet provision is not simply a matter of convenience; it is fundamental to their dignity, safety and independence. Many people living with a stoma feel anxious about leaving home, particularly in the period after surgery.

The Government recognise that being able to live well, to work, to enjoy days out, to shop and to socialise requires access to appropriate public toilet facilities. However, as Members across the Chamber have said, standard public toilets may not always provide that facility for everybody in a safe and dignified way. It is important that we recognise the specific experience of people with invisible disabilities, who are often uneasy about using a disabled facility for fear that it may be a challenge to do so—assuming that the disabled facility would even meet their needs.

In recognition of the importance of this subject, at the last spending review, in 2025, the Government committed more than £5 billion over the next three years for essential local services, including public toilets, and we continue to provide 100% mandatory business rates relief for stand alone public toilets, which is helping reduce ongoing costs for local authorities, but I absolutely accept that the facility needs to exist in the first place. I recognise that, for stoma users, practical features such as clean shelf spaces and discreet disposal bins can make a significant difference. I thank Members for raising the issue of facilities in male toilets, which are so frequently overlooked.

It is worth highlighting that all building work must meet the functional requirements of the Building Regulations 2010, which address accessibility and provide guidance on meeting those requirements, including the installation of shelves, sanitary disposal units and accessibility toilets. However, I accept that the very fact we are having this debate means that the reality on the ground is very different.

The Building Safety Regulator has a duty under the Building Safety Act 2022 to keep the standard of buildings under review, and I welcome the fact that the Opposition spokesperson, the hon. Member for Mid Bedfordshire (Blake Stephenson), drew attention to the £30 million Changing Places programme, which supported the targeted installation of almost 500 new disabled toilet facilities. I learned much about that programme when I served as a council leader—if I learned anything from my days in local government, it is that bins and toilets are two topics that people get very passionate about.

The role of local authorities is central to this conversation. It is the Government’s view that local authorities are best placed to understand the needs of their communities, and to make decisions about the provision that is right for their areas. I take careful note of the important arguments made about statutory requirements and regulations, but I say gently that local authorities might not think that is the best approach. I am yet to come across a local authority that does not want to do the best for its area, and I think there is a conversation to be had about how we can better support them to do that.

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 spirit, I welcome continued dialogue with Members. I know that there are others who are not in this Chamber who also feel very strongly about this topic. Local government, MHCLG and partners can work together to deliver more accessible, well maintained public toilets. We should look at existing schemes and new schemes that can encourage such provision.

I thank hon. Members, particularly the hon. Member for Strangford for securing this important debate and for his warm words in welcoming me to my place; it was very generous of him. The Government recognise the importance of ensuring that public spaces are accessible, inclusive and supportive of people’s dignity and independence. I welcome further representation from hon. Members, the brilliant charities that do fantastic campaigning on this issue, local authorities across the country and other partners who want to see the provision of public toilets improve.

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, we will get a lot more out of it. Toilet access has a big impact, as it protects people’s dignity. Some 40% of toilets in the UK have disappeared. They are a public necessity, and surely England could do better. Public toilets must be a part of modern society.

The shadow spokesperson, the hon. Member for Mid Bedfordshire (Blake Stephenson), also brought knowledge to this debate. He referred to the 200 to 250 people in his constituency who have had a stoma in the last year. He also referred to the “Boys Need Bins” campaign, which others have referred to, and which those in the Gallery have made us very much aware of.

The disability is invisible—we need to remember that. I know about stomas only because of friends and constituents. Under the previous Government’s Changing Places policy, the number of toilets has risen, which is good news, but there is a lot more to do. I think the hon. Member for Mid Bedfordshire referred to that as well. He also asked for a meeting with Colostomy UK—I think we can help each other on that.

I congratulate the Minister on her debut in Westminster Hall. I wish her well in the role that she has chosen—or that someone else has chosen for her. [Laughter.] It does not matter; it is a role that she is capable of. On behalf of our constituents, I was very pleased with her response to us as individuals and collectively as well. She referred to the 13,000 each year who have the stoma operation. Independence for people with such a disability is important for them to live a normal life and not be conscious of all the things that can happen. The standard of public toilets needs to be up to a certain level. The hon. Member for Fylde explained things about going to the toilet that I had not thought of or even conceived of, but he explained it very well. Only then do we realise how important it is to have a certain standard of toilet.

Local authorities were also referred to. The Minister gave us some assurance, which I am very pleased about, in relation to the 10-year plan and how the scheme will change from analogue to digital. It is important that we look at ways of doing things better.

Again, I thank you, Mr Dowd. We do not often say this, but we should thank our Hansard staff who come along and decipher our words, or my accent or my Ulster Scots isms or whatever it may be. I thank them and the civil servants who come along and dutifully listen to all the things we have to say, take notes and never show emotion. That is the standard of a good civil servant.

Question put and agreed to. Resolved, That this House has considered public toilet provision for people with stoma.

Sitting adjourned.