20th April 2026

Newsletter Monday

Reader

I’ve scrolled past a lot of headlines this week.

War.

Politics.

The usual loud, urgent, attention-grabbing noise.

And then I stopped on one about… public toilets.

Which got my attention mostly because it’s so ordinary.

I am more concerned with ordinary than international politics, if I’m honest.

So whilst this sounds deeply unremarkable,

it isn’t - if you’ve spent any time actually listening to patients.

It’s about what people don’t do because of them.

I can think of patient after patient who has, at some point, said a version of:

And what they really mean is:

The scale of the problem.

Many women in the second half of life are managing some degree of bladder control problems.

Most can’t relax unless they’ve clocked the nearest toilet within about 30 seconds of arriving somewhere new.

This happens gradually and rarely gets discussed.

Women with heavy periods don’t just “pop out” for the day without a plan.

Not only do they need to know where the toilets are, they may need to be close enough to the car in case a change of clothes is needed.

Flooding through underwear and clothes is NOT rare.

People on medication that makes their bladder far less negotiable than it used to be - long car journeys represent a new level of wee-stop planning.

I used to look after someone whose bowels were so unpredictable, any journey became too much of a risk to bother going.

Patients with disabilities aren’t just looking for a toilet - they’re looking for one that actually works for them.

One that’s not locked, or out of order.

So without a degree of certainty around this, people just… don’t go.

Don’t go into town.

Don’t go for the walk.

Don’t go somewhere unfamiliar.

And without knowing the details we call this “getting older”

or “losing confidence”

or sometimes even “low mood.”

When actually, quite often, it’s logistics.

Planning Committees

The article says public toilets have fallen by 14% in a decade.

14%.

That’s not just fewer places to wee.

That’s fewer ways to live normally.

What’s interesting is how this never quite makes it into the meeting room where decisions are made.

Because if you’re that person on a planning committee who might have experienced this, are you really going to stand up in a planning meeting and say:

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No.

I’ve sat in countless meetings like this.

It doesn’t get said.

And if it doesn’t get said, it doesn’t get prioritised.

Instead, we end up debating toilets as if the only issue is signage.

Male.

Female.

Unisex.

As if people just need a quick, straightforward visit and that’s the end of it.

It’s not.

For a lot of people, toilets are the difference between:

• going out vs staying in
• feeling in control vs feeling constantly on edge
• being independent vs quietly shrinking your world

This doesn’t trend.

It doesn’t go viral.

It doesn’t sell anything.

But it’s one of those small, practical things that tells you a lot about how a society is functioning.

Because if people are planning their lives around whether they might get caught short…

That’s not a minor inconvenience.

That’s a loss of freedom.

And no supplement, app, or mindset shift is going to fix that.

You just need a toilet.