Why Accessible Toilets Decide Where We Go And Who Gets To Be Welcome

Need a quick test for whether a city is truly inclusive? Follow the signs to its toilets. We sit down with Gail Ramster from the Royal College of Art’s Helen Hamlyn Centre for Design to unpack how public restrooms quietly govern freedom of movement, confidence, and dignity—especially for people with continence conditions, disabilities, caregivers, and families on the go.

Gail takes us from Victorian ideals to today’s fractured reality: underfunded municipal facilities on high streets versus the polished, well-maintained restrooms you find in malls and airports. She explains why there’s no single “perfect” accessible toilet—because needs can conflict—and shows how a smarter system offers multiple layouts while raising the usability of standard stalls. Think low-force taps and locks, reachable soap, intuitive wayfinding, and lighting that reduces sensory overload. We dig into the Great British Public Toilet Map, an open-data project featuring roughly 15,000 publicly accessible toilets across the UK, and how that database helps people plan trips with confidence and reveals “toilet deserts” where provision lags.

We also explore culture and technology. From Japan’s Tokyo Toilet project and the wellness-centric mindset to the promise of privacy-preserving data that aligns opening hours and demand, there’s a clear path to better access without compromising dignity. Along the way, we talk about community toilet schemes, the economics behind cleaning and maintenance, and why businesses sometimes benefit from treating restrooms as part of the customer journey. Gail closes with candid advice for early-career designers: be brave, listen deeply, and let lived experience reshape your brief.

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Chapters

• 0:00 Meet Gail Ramster And Scope
• 2:17 Why Toilets Are Taboo
• 4:02 Funding, Policy, And Access Gaps
• 5:17 Private Sector Versus Public Provision
• 6:38 Mapping Toilets Across The UK
• 9:28 Design Research And Lived Experience
• 12:28 Conflicting Needs In Accessible Design
• 15:48 Global Lessons And Smart Toilets
• 18:12 Data, Technology, And Provision
• 20:02 Community Toilet Schemes’ Tradeoffs
• 23:32 Toilets As Customer Experience
• 24:48 Career Advice And The New Book
• 26:52 Where To Find The Book And Closing

Transcript

Neil Milliken: 0:00

Hello and welcome AXSChat. It's just Antonio and myself today. Deborah's not with us, but we are joined by Gail Ramster, who is a senior research associate at the Royal College of Art, Helen Hamlin Centre for Design. Now I know that we've had people on from the Helen Hamlin Centre before. I'm a big fan of the work that they do. They're the world's number one design school and have a focus on inclusive design. So welcome, Gail. I'm I'm delighted that you're here because we've been talking on and off for nearly 15 years on a topic that is close to my heart and close to yours as well, and that's toilets. Um might not be uh like everybody's cup of tea, but you've recently written a book as well. So can you tell us a bit more about yourself and then also about we the people?

Gail Ramster: 0:50

Thank you. Yes, it's very nice to be here. Um so I've been a researcher in inclusive design for 16 years and interested in public toilet design for even longer than that. It's an area that I came to first with a background in engineering, so I was interested in ergonomics and how to design things for people, and the public toilet just seems like a space which has had so little design interest historically, particularly initially in terms of ergonomics, just how do you even manage this space, even though it's a space that everybody uses every day, so it's not like there's a lack of users or experience, but just not something that people take that much interest in. And then over the years it's evolved from an interest in ergonomics to product design, service design, architecture, communication, wayfinding, it's sort of it touches on all aspects of design and then also feeds into society and gender and the built environment, so it's really an endless topic for inclusive design.

Neil Milliken: 1:48

Yeah, and and um I guess there's an awful lot just to unpack in in just the the introduction that you've just made. Firstly, if everybody uses these things, why is it that people don't talk about them? You know, is it the taboo of uh, you know, of the of of the toilet function and our bodily functions because we like to pretend that we don't weed or poo? Or is it just because we think it's so mundane? D do you have a view?

Gail Ramster: 2:17

I guess it's a bit of both. Um recently I've been thinking more and more about the toilet taboo with my colleague Joanne Bichard. We've just published a paper on it, in fact. Thinking about how our kind of societal disgust with waste has fed into public toilets. Like the Victorians built this, our historical system of public toilets, as a way of supporting the mass population and encouraging cleanliness. And yet, since these were built, they've just sort of been ignored and allowed to fall into disrepair. Sometimes because they're never going to be up to scratch, so a better design comes forward. So a lot of the public toilets were built in the subsoil, which automatically makes them inaccessible. But I think also there is that aspect of it being a municipal facility in the public space. It's seen as council-owned and therefore not owned in a way. We don't treat public property well. I don't know if it was better in Victorian times, but these days these are the municipal objects in our streets are the ones which are vandalised and graffiti. So perhaps public toilet suffers from that association as well. And if they are owned by a uh shopping centre or by a community group, then they all either have the oversight to keep them in better nick, or they might be less susceptible to misuse in the first place.

Antonio Santos: 3:40

Where do you think that the problem starts? It starts with the requirements that are put out there in order to for the toilets to be built, or starts then in the offering that those who apply to build those toilets put together to compete and to have their no, let's say uh to be able to move forward with the requirements of building.

Gail Ramster: 4:02

So I guess some of the problem is financial, that the councils don't have the money to build or rebuild what already exists. They're very expensive, and councils don't have to provide them at all, so they can't protect budgets to do so. And then as our country has become better at inclusive design, then we have recognised that a lot of the public toilets as they were first created were not suitable. Um so the Disability Discrimination Act would have highlighted that a lot of the toilets were not wheelchair accessible, for example. So we have subsequently, as a nation, built a lot of wheelchair accessible facilities. But in some cases that might mean that a public toilet closes down because it's not accessible and becomes less used and isn't replaced in as well a means as it should have been. Um a lot of our toolers are slowly getting better, but it's not necessarily the councils that are building them.

Antonio Santos: 4:57

You think that in the public in the private sector we're doing better now in big places like airports, uh shopping centres and so on?

Gail Ramster: 5:06

Yeah, I do think they're doing a better job. I think um, and this is partly speculation, but in economic terms, the shopping centres and the businesses and the airports recognise that this is a critical part of infrastructure for their visitors, um, and so they build them as part of part of infrastructure and also part of user experience. So you're going to choose the shopping centre that has the nice toilets that has space for baby changing and feeding, as well as having free parking and all the other reasons why people started to move out of the high street and go to out-of-town shopping centres instead if they have the space. But I guess another advantage is that a shopping centre or an airport has like one landlord, it has one body to make all of these decisions. Whereas the council has a much trickier role. It doesn't have the property. Um, the businesses on a high street don't have the means to collectively build their own toilet unless it's within a shopping centre. Like a council is not a landlord, so it's sort of providing these facilities for the public good as part of a public service, but not as a means of generating income in quite as direct a way as an airport or a shopping centre would, where they can kind of see that people are dwelling for longer because the toilets are good.

Neil Milliken: 6:21

Or even in an airport flowing through faster. Yeah. Because they've got enough facilities, because movement through an airport is really important. Um, because they're you know they they only want you to dwell at the point where they're selling you the goods in their own shopping centres. The rest of the time they want you to move through quickly. So taking on board that the fact that we have certain areas where we've got all of these nice shiny new facilities, but that they tend to be out of town, and then we have a a sort of sparsity of public facilities in the traditional high streets and stuff like that. I know that that often people who need toilets because of health conditions and disabilities struggle to find them. Now, you may not have mobility users, you may not even you may not need a disabled toilet for your disability, but you need a toilet because of your disability or long-term health condition. I know that you'd done some work previously looking at mapping toilets and and that this this this is really a crucial part of the sort of information infrastructure to support people. Where did you start with that and how how is that now is that integrating into tools like Google Maps and and Apple Maps and the tools that people use daily?

Gail Ramster: 7:36

Yeah, so we ran a research project called TACT 3, funded through the Economic and Social Research Council about, well, 15 years ago. Um which was looking at the environmental barriers to accessing public toilets, particularly for people with confidence conditions. And it was exactly as you say, like there was no perfect public toilet out there. People's needs may be so diverse that it wouldn't even be possible to have one toilet that solved everybody's needs. But what we did have with this was this myriad of provision between the public toilets provided by the council or the publicly accessible ones, whether those are in public buildings like libraries or in train stations or shopping centres or whatever. So what we thought we could do, what I thought I could do, is map where those toilets exist so that people are at least able to find a toilet that meets their needs, even if not every toilet does. And there was no government database of toilets. So if you wanted to add it to an app or a map, it wasn't possible to do those local design solutions. So we built a website called the Great British Public Toilet Map, which is now called the toilet map, and which now has 15,000 publicly accessible, publicly available toilets across the UK, which compared to the official statistics of how many public conveniences there are, that's about 3,000 in England and Wales. So we've identified five times the number of toilets that you could be using as a sort of first step to helping to improve the service, kind of know what exists and what therefore doesn't. And it is being used by researchers and it is open data, so anybody can get in touch and pull that data through an API or through a download into their own applications.

Antonio Santos: 9:10

On that topic, uh what type of um two questions? What type of um responses you received after the launch of the map? And then how do you see the role of design in addressing societal issues in like accessibility and inclusion?

Gail Ramster: 9:27

So the map was really well received from users. We have a big file of thanks, particularly people with continence conditions or whose family members have continence conditions, because it allows them to plan their trip from home. So it's not that they're out and about and looking this up on a phone, although that's possible. It's making sure that there will be something to use when you go to a new place. And if you don't have that information, then you don't go anywhere new. So it does make a big difference. Um, it's a crowdsourced project, so we still need more and more data and more and more information about the torches that we already have to constantly improve the information, but it's got enough for it to be worthwhile people doing that. So we have about 10 to 20 edits each day, which is great. The role of design and accessibility in general. Our approach as design researchers is always to speak to people who are excluded by design, who to understand their lived experience and make sure that designers or architects are solving the right problem and not the problem that we assume there is. So that's a step that I think is skipped a lot. Either designers think they know what the solution will be, or there could be too much reliance on standards and guidance, which are provided to help people design the best that they can, but unless you understand how that guidance came about and the user need behind it, it's very easy to make mistakes and not realise the ongoing implications of that. And also, like inclusive design just continues to expand to more and more needs. So another researcher here, Katie Gurdion, does a lot of work around neurodiversity. And recently she's been working with the inclusive, with the intelligent mobility design centre here, research centre, looking at design um neurodiversity in the streets, so in the built environment and all the different sensory overload experiences that happen there. And then Katie and I have been working together looking at internal public spaces because there's a huge crossover, even between public toilets and um neurodiversity and all the different stimulus that you might experience. So it's a really interesting place to research, but it also means that everything that we might previously have thought of as best practice within inclusive design now needs to be kind of reconsidered to figure out whether it's still the best standard, I guess.

Neil Milliken: 11:36

I think that that then plays back to what you were saying before about there being no one perfect design. There's no one perfectly accessible thing, let alone toilet, because needs are very personal to each individual condition. And even within the the sort of umbrella of neurodivergent conditions, the needs often conflict as well. Um you know, you what works for one person won't work for another. So I do wonder whether the sort of decommissioning of public conveniences because they're not accessible for a particular group based upon mobility criteria, actually then is disabling for another. So I think that that the research you're doing is really interesting because it's starting to sort of make us think in a more nuanced way about what's accessible.

Gail Ramster: 12:28

Yeah, and there's there's really interesting examples within toilets that we often use, like the accessible toilet, which has enough space for a wheelchair user to make a transfer, that always has the toilet next to the wall and to give that stability. Whereas the change in places toilet for people with profound or multiple disabilities has the toilet positioned in the centre of the wall so that because you might have two carers that need to access from both sides. So already you can't count a change in places toilet towards your accessible toilets provision that they're kind of directly opposed designs. Um, so in some cases, in order to give equitable access to the built environment, you need to have different designs for different groups. But at the same time, there's so much that could be done for the standard toilet to make that more inclusive to then take demand off these other facilities. So just by having a lock, a flush, a tap, a soap dispenser that people could use with arthritis or with reduced hand strength that children could use, that would make the standard toilet more accessible to a lot more people who might be using the wheelchair accessible or accessible toilet now, um, who don't necessarily need that amount of space. So whilst all disabilities or disabled people can use that toilet if they need to, the sort of disabling people by not making the standard toilet more accessible in the first place. You get this certain argument.

Neil Milliken: 13:46

That makes that makes perfect sense. And your focus has been on the UK so far?

Gail Ramster: 13:52

Yes.

Neil Milliken: 13:52

Or have you have you looked at toilets in in other countries? Because I think I think there's a a real difference in international attitudes to toilets and toilet design. And there's still some parts of the world where you have the the sort of the the foot plates and and people squat over uh you know a porcelain hold.

Gail Ramster: 14:14

Yeah, which is a physically better way to use the toilet if you've got the leg muscles to sustain it.

Neil Milliken: 14:22

Yes, well, but my I had I mean that's quite common in Southeast Asia, and you know my my brother-in-law is a lot older than me, and at one point was able to get down, couldn't get back up, and the walls were just too far apart to use the walls as a way to get back up. So I think you know, even if you have those kind of designs, you still need to think inclusively. And then on the on the other side, you've got the trend for computerized robot toilets from Japan that are um doing everything from sort of drying and cleaning you to using AI to monitor your stools for your diet and internal health.

Gail Ramster: 15:05

Does seem like quite a sensible thing to do if you've got the uh technology. It's better than my washing machine trying to talk to me through my phone. Like that. It would be it's a good health of a smart toilet to be able to tell you if you've got a a condition. Yeah, Japan has fantastic toilets we've seen where I haven't been. We've only looked at other countries sort of recreationally. But the fact that Japan has the Tokyo toilet project, which got a lot of publicity in the last few years, including a feature film, which is excellent. Perfect days. The film just showed how inclusive these are, uh, whether it's like the hose, the b-day attachment to wash yourself, or particularly if you've got like a stoma that you need to maintain. Like there's there's ways designed into their toilets to keep yourself clean. So that it's just they do provide public toilets in a way that appears to recognise them as essential, inclusive, and almost celebrate them as the place for wellness and hygiene rather than associating them with the waste that is disposed of. And that's something that we could really learn from, providing public toilets, but providing them in a way that we're proud of and see. Like post-pandemic, we should be thinking far more about hygiene and wellness and shade and drinking water and respite and taking a break and spending time in amongst other people in social spaces, which the public toilet can meet all of these kind of community needs, rather than putting them in the corner down the alley behind the bins and forgetting about them.

Antonio Santos: 16:25

On the topic of technology, what role does technology play in your work and how do you see it shaping the future for urban design and public services?

Gail Ramster: 16:35

I'm not sure that I've looked that much technology or AI in terms of public toilets. I think there's more that we could do with the map in looking at heat maps of where people need toilets or where people are when they want the toilets. There's a lot of data that could be gathered in a way that Google Maps do to look at that. And in terms of like opening hours and where people are congregating, like there's a lot of information there in mapping that could be mapped against the public toilet map. And against businesses. So there's a lot of data. I think it's MasterCard have data showing. Which basically shows when businesses are open because there are so many transactions that you end up with these heat maps of when businesses are open, and that's a really more much more efficient way to gather information about the built environment than searching through thousands of opening hours and websites. So for pulling data like that, I think there's a really useful um, there's an opportunity there for using technology or AI better to map need against provision.

Antonio Santos: 17:32

Last week we talked, we were talking with David Baines, and he was telling us that sometimes data with people from disabilities is anonymized. So we don't know where they are and what is in there. And in this project that you have, you feel that people are willing to share valuable data with you, let's say their location, the time, the time that they move, when they need the facilities, what type of experiences do you have there?

Gail Ramster: 17:56

So we haven't tried this yet of kind of mapping. Um we try to collect as little information as possible through the toilet map in terms of cookies so that it doesn't put people off. But if simply where their location is when they open the map would tell us a lot about where people need the toilet without them having to enter any more data than that. Uh yeah, but I do it is a data set that is rich for more research to find out where the deserts are, as someone coined it. And also just the difference across the country. Some areas have great facilities and there might be community-run facilities, so a lot of kind of local expertise, and other areas might be really struggling, but could be learning from each other much more. It's always hard to know whether to go kind of top-down and look at national or global data, or whether to look at high-college cases and yeah, look at it that way.

Neil Milliken: 18:43

Do you find that that some of the sort of like you mentioned MasterCard having data on on sort of business opening hours and stuff like that? And Google and others have quite a lot of data about businesses. So if you go into Google Maps, you quite often see, you know, whether a business is busy and you can see sort of peak hours data and stuff like that. Have you found that the the businesses are willing to share this data, or do they see that you know some of the data that they hold is a competitive advantage and therefore it doesn't get released for use as a public good?

Gail Ramster: 19:22

Um well it's not something I've inquired about. Like, well, in the past when we've asked sort of national chains for data around their public toilets, we haven't gotten anywhere. So a supermarket might have at one point said that anybody could use their toilets, but unless they provide a data set saying which of those supermarkets have toilets, it's a bit useless. And you have to tool it yourself to find the information. I was thinking. Oh, yeah, there's a lot, there's a so there's a recent trend at the moment, well, probably about 20 years, for some councils to um approach mostly small businesses to ask that anybody can use their toilets sometimes in exchange for a stipend um or sometimes just for community good. So these community toilet schemes kind of supplement the more public toilet provision. And that's working quite well in the areas um where it's operating. So I've just run a week a workshop with councils in London for a project called The Places We Go, which is looking at a best practice for community toilet schemes in London and how different councils are approaching it. And yeah, at the local level, there are lots of businesses which are happy for the general public to use their toilets, but there's quite a tension as to wanting to publicise the scheme so that they know that this is a worthwhile service and that people are using it, but at the same time not to publicise it so well that the businesses end up overwhelmed and feel that they're providing a public toilet. And it's also tension of not wanting to have a sign up saying toilet because the businesses want to look like a toilet, but at the same time, you need to have that information for people to know that there is one and that you're allowed to use it. So it is a weird area of how much businesses can be expected or are willing to provide this service on behalf of the council in a way, um, and still this taboo of not wanting to be a toilet, even though the toilet is often the reason people went in in the first place, whether they're a customer or not.

Neil Milliken: 21:20

Yeah, I think I think I can understand the tension sometimes if you're a small business and you've got loads of people passing through your doors and they're not spending any money in your business. And you have to keep it clean.

Gail Ramster: 21:35

Yeah.

Neil Milliken: 21:36

And so if there's loads of people passing through, you know, not everybody keeps everything as clean as you would like. You know, we've we've visited plenty of public toilets. I'm sure you've visited plenty of public toilets, and some are nicer and cleaner than others. And even the clean ones depends on the time of day. So if you're a business and you, you know, your business is predicated on you maintaining a nice premises. If you've got loads of people coming through, then there's there's definitely uh an impact on the running of the business from doing that. So you can understand why there is that that tension, but there's also that sort of thing that we were talking about before, the sort of taboo about the the sort of, as you said, it's we associate it with the removal of waste and unhygienic stuff, whereas the Japanese culture is actually it's about health and cleanliness and and so there's a sort of a different positive framing around it, I guess.

Gail Ramster: 22:32

Yeah, and that kind of view of not wanting to be treated as a public toilet. But if we didn't treat public toilets so badly in the first place, then this wouldn't be quite the same fear. And it's not always like external people that are making a mess of the toilet either. It could be people's customers in the first place. Oh, there's a lot of stuff. Yeah, there's a lot of sort of fear of the unknown. What I'm always surprised by is the national chains which are reluctant to say that they have a toilet. Because I I mean, I heard this week that cleaning costs are so high that it does become um a challenge just to keep toilets clean for customers, and then feeling that that use is going to increase could be a big pressure. But thinking about like a uh an out-of-town retail park, like alongside the motorway, normally only one of those units has a toilet, it has a cafe as well, which is why it has a toilet, and people will visit the shop that they want to visit, but they'll also go in the BQ or whatever it is, because it's got a cafe, but also because it's got a toilet house. No one is spending time on these retail parks otherwise. But why pretend otherwise? You're you are John Lewis was always very good at recognising that people were going to their shop to use the toilet, so let's make them nice, and then you can market to people on the route to the toilet. So there are lots of opportunities once you get people through the door to turn them into customers. So the toilet is actually an amazing selling point for getting people in the business in the first place.

Neil Milliken: 23:47

Absolutely. I mean, in terms of merchandising, John Lewis know what they're doing.

Gail Ramster: 23:52

Yeah.

Neil Milliken: 23:52

So Kingston store. There's some toilets on the first floor. And guess where they locate all of the women's clothing sale racks?

Gail Ramster: 24:02

Probably fallen foul of that myself.

Neil Milliken: 24:04

Yeah. So um so you come up the escalators and you have to pass the women's clothing sale racks twice. Um on your journey to or from the toilet. So yeah, there is definitely a merchandising opportunity there as well.

Antonio Santos: 24:19

Yeah, you go to the toilet to take some pics for Instagram.

Neil Milliken: 24:23

Yeah.

Antonio Santos: 24:28

We are not a few minutes from the end of the show today. So there's something that I would like to ask because I think it's also relevant to a part of our audience, particularly people who are starting their careers. I know. I would like to know you to give a kind of uh an advice to your younger self when you're just starting out in design and research. What advice would you give?

Gail Ramster: 24:49

Oh, I've never been asked that. I think to try and be brave and find the opportunities to talk to people about what you're researching. Like it's the bedrock of inclusive design to not assume and to always keep learning and keep hearing new experiences. But it's also quite nerve-wracking speaking to strangers and engaging the public. And it's very easy with a topic like toilets to think that we already know. And yet, after 15, 20 years looking at this topic, whenever I talk to somebody, I learn something new, and I'll hear an experience that I've not heard before, and it will mean something, and it will kind of inspire me and motivate me to keep drumming away at a subject that's not very glamorous, and which I've tried to move on from several times, but keep getting pulled back because there's just so much to do. So, yeah, be brave.

Neil Milliken: 25:36

Fifth 15 years in the loo is a is a long time.

Gail Ramster: 25:39

Never mind, new books.

Neil Milliken: 25:40

So hold your book up um and and tell us where can we find the book? So it's called We the People.

Gail Ramster: 25:47

Yeah.

Neil Milliken: 25:47

Designing inclusive public toilets. Where can people find it?

Gail Ramster: 25:51

Well, online, all bookshops online, Waterstones, Bloomsbury's websites, Amazon. Yeah, about £15 at the moment, I think. And it has lots of images of uh best practice as well. So it's not too much reading and some quite nice stories, and lots and lots and lots, as I was just saying, of user quotes. So it's really easy just reading the quotes to understand where people are coming from and come up with ideas for yourself as to what would be a good design that can meet this need. It's not necessarily what's already out there. So these things can keep evolving, but understanding what people are dealing with and then trying not to exclude anyone is uh critical.

Antonio Santos: 26:27

Have you done uh have you signed any books at bookstores? Have you done any presentations like that?

Gail Ramster: 26:33

We had a book launch at the RCA, and Joanne and I are speaking on a round table at RIBA next month. So that's something to look forward to. And we did an inclusive hygiene campaign with Essity, who have a brand talk who provide lots of um hygiene products within toilets, so toilet paper dispensers, and where we met lots of interesting people from around the world who also work in inclusive hygiene. So that was a great opportunity. So yeah, it's um no public events yet, maybe the RIBA one. Have a look.

Neil Milliken: 27:00

Yeah, for for people that are not from the UK in our audience, RIBA is the Royal Institute of British Architects. So thank you so much, Gail. It's been a real pleasure. Um, I'm very happy that you could join us today. And I hope that lots of people read this book because it's a really important topic. People need to be able to have access to toilets to be able to participate in society. So the work that you're doing is really important, even if it isn't glamorous. So thank you very much. And also thank you to our friends at Amazon for supporting us and keeping us on air. And we'll speak to you all next time.