A public inconvenience

Luke Blair
By Luke Blair     16/11/2022

“Now that’s a text I never expected to receive…” said the director, after I sent him a message saying: “meet you at the toilet.”

It was a rare, light-hearted moment in an otherwise rather stressful journey that took over a year, many dozens of emails, an architect, specialist equipment providers, and the involvement of most of the hospital’s estates and facilities team at one point or another.

That journey ended this month, Disability History Month, in the grand opening of what is known as a ‘Changing Places’ toilet. “I am delighted to be opening this local facility,” said the local councillor, who had kindly agreed to lend some civic ceremony to the opening of what was, after all, just a toilet.

But of course it was not just any toilet. Changing Places toilets are built to a very precise specification. The idea is that the estimated 250,000 people who need help simply going to the loo have a decent, clean, safe and dignified place to do that, on the basis that this should not be too much to ask in a society that looks after its people.

Changing Places toilets therefore are large – some 12 square metres inside – and fitted with a height-adjustable adult-sized changing bench, a ceiling hoist with a track, a height adjustable basin, and other key equipment. They might seem small items of specification, but if you are disabled, each one makes a big difference.

So getting them right is important but in a hospital, it seems, not that straightforward. The first issue turned out to be the location. Finding a spare 12-metre space was not easy. And this one had asbestos in it. It was also not that easy to locate being, somewhat counter-intuitively, on the first floor. Which means that wayfinding and signage was also an issue.

There then was the toilet seat colour, which visually impaired people need to be able to see, and a shelf for stoma bags – as you can imagine, having this in the right location at the right height is also a small, but critical issue. Not to mention the door which, when the facility was opened by the councillor, was not actually fitted in time.

All these seemingly small hurdles are insurmountable if you are in need, and therefore have to be overcome if you are to provide for people’s needs. In other words, it is the small things that count, not the big decisions. No-one is going to say: “We’ve decided not to provide facilities for disabled people.” But they might say “We can’t get that item fitted this month.”

If those small items cannot be provided and the small hurdles overcome, the impact is so much bigger for those in need. There is another analogy that makes the point, perhaps more emphatically and, for me, more personally.

This is called the Wheelchair Challenge and is an exercise offered by colleagues in the hospital to highlight inaccessibility issues. The simple idea is that you, or in this case I, get in a wheelchair to follow an actual user as they navigate their place of work.

It is harder than it sounds. For 90 minutes during my challenge, I struggled up what I thought as a non-disabled person were perfectly adequate ramps. Turns out some of them were just impossibly steep. I also found myself at one the main entrance doors to my office in the hospital with both hands on the wheels (as there was no level surface at the top of the ramp) needing somehow to swipe my security card (from a sitting position) and push the door open at the same time. It turned out that this door – despite having a ramp – was actually impossible for a wheelchair user to open.

A similar, seemingly small issue applies to kerbs. Turns out not all dropped kerbs are the same height and if you try a ‘wheelie’ to get up a kerb two inches high, you can end up on your back and out of your wheelchair, surprisingly fast. For me, the Wheelchair Challenge was just a once-in-a-lifetime event. For others, living this life every day, the constant, cumulative effect of these small obstacles can be devastating.

As part of Disability History Month, some personal thoughts were gathered from colleagues about their struggles to overcome obstacles with what, in the world of work and disability, are often called ‘reasonable adjustments’. Their comments are hard to read.

They say things like: “I would have loved to have felt that I had someone to support me – I felt very alone throughout this process.” And “It's getting to that stage now where I'm getting to the end and often I haven't got much more fight to give, I really haven’t.”

These are not things you want to hear from anyone, let alone colleagues in your own organisation, your own place of work. Because if we have learnt anything about achieving a society that looks after its people, through better accessibility to basic needs, it is knowing that when something is not usable, suitable, or even just convenient, for one of those people, then it is not that person who is somehow at fault, but us. We made or designed that thing or process in a way that excludes them. So it’s up to us to fix it, whether it’s an office door, a dropped kerb, or a toilet.