Urinating in public made the headlines this week with the news that at least two men have recently been fined for doing so in the Hertfordshire countryside. Dacorum council and many others class the act as a littering offence. A Royal Society for Public Health survey in 2019 found that three in four people in the UK reported a shortage of toilets in their area. A decline in the maintenance of public facilities over the years has left many, including older and disabled people and those with young children, having to plan carefully or being forced to rely on private businesses. It has also significantly affected gig economy workers and people sleeping rough. Four people explain the impact the reduction in public toilets has had on their wellbeing. ‘Another thing that makes life with chronic illness harder’ Annie, 72, who has multiple sclerosis (MS) and related bladder problems, said the availability of accessible public facilities had worsened over the years in her area. “I used to know the location of pretty much every public toilet in Bolton town centre, but these are now fewer and not always easy to access,” she said, explaining she has mobility problems. Annie has an MS card, which gives her access to hospitality venues’ facilities, and a Radar key to open locked public loos. “The M&S in the town centre, which was so handy, shut last year. It’s been an issue since well before the pandemic,” she said. Things may be changing, however, after Bolton council last year announced a £225,000 scheme to create more disabled toilets. Progressive MS and concerns about accessing facilities mean Annie has moved much of her social life online to Zoom. “I plan fewer outings than I might otherwise do, and it limits where I can go. If I’m not going to have access to a toilet, I try to be home within an hour. Sometimes this proves too long, leading to ‘accidents’ which can be embarrassing and uncomfortable.” She said she limits fluid intake if she has to go out for longer than an hour. “The lack of public toilets is just one more thing that makes life with a chronic illness harder than it needs to be.” ‘Children need the toilet very frequently’ For those with young children, a lack of public toilets can make planning a day out unnecessarily complicated. John Zhang, 40, said his visits into the central London with his partner and five-year-old daughter had become less frequent due to this. “It’s hard to find toilets, unless we pay £3.95 each for coffees or go to museums. I have to plan ahead where to take my child – children need to go to the toilet very frequently, they can’t hold it. And sometimes in small cafes, there’s not always a toilet [for customers]. It takes away the enjoyment of visiting.” Zhang, a tour operator, has noticed this decline over the past decade, and believes it negatively affects tourism. “You see more people just peeing in the streets now – it’s not good for the city’s economy and small businesses. Tourists complain that they can’t find toilets. Sometimes, when there are public toilets, you have to use coins to pay – [but] not so many people carry cash and they often don’t give change. It’s not nice to see people peeing in the street, and if you gave them a choice they wouldn’t.” ‘It is a source of anxiety going anywhere new’ A shortage of facilities means Bob, 70, can struggle with going to unfamiliar places. “Like many men of my age, I have an enlarged prostate, meaning I need to urinate frequently and often at short notice. You need to have a constantly updated mental map of public toilets, which is possible for my local area but it is a source of anxiety going anywhere new.” Bob, who is retired in East Sussex, said it had been a problem for years, including in Norwich and London, where he previously lived. “There aren’t enough public toilets where I live – many have been closed in recent years and not replaced.” He sees the issue as part of a wider trend towards privatisation of public spaces and facilities. “I am concerned that the trend to close public toilets and rely on access to commercial facilities will continue until the very idea of ‘free’ public services disappears.” ‘There is evidence of soiling in public areas’ Others pointed to the degradation of the environment and their local area. Elspeth, a retired teacher in mid Wales, said she worried that local councils could close some toilets in the national parks where she enjoys spending time, with public health implications. “There are still some public toilets in Pembrokeshire and the Brecon Beacons. [In places] where there are no toilets there is evidence of soiling within car parks and nearby hedgerows, which is revolting and unsafe,” Elspeth said. In Wales, the Public Health (Wales) Act 2017 requires each local authority to produce a local toilet strategy. Elspeth drew a comparison with New Zealand, following a visit there. “I have been astounded by [their] quality and quantity of public toilets, even in the most remote locations. This investment in a public need has meant their countryside has remained pristine. Their toilets put us to shame.”