Got a question for Wes Streeting, Secretary of State for Health and Social Care?

[JustineMumsnet]

Hi all,

Next week we’ll be back in Westminster to put your questions to the Secretary of State for Health and Social Care, Wes Streeting MP.

His brief covers some big areas that we know are really important to Mumsnetters - including maternity care, access to GPs and dentists, mental health services, social care, public health, and how we keep the NHS sustainable in the long term. If you’ve got a question you’d like me to ask, please post it below.

As ever, one question per user please and keep it civil. We’ll be tight on time, so please keep questions short and sharp, so I can get through as many as possible.

We’ll close the thread on Wednesday pm - so do get your questions in before then.

Thanks,
Justine

Could you investigate and correct the GMC recording the acquired gender of a doctor rather than the birth sex.

Wes wasn’t talking just about toilets he seemed focussed on patients in wards etc
From what he said I’m taking it to assume trans patients will be in seperate rooms with en-suites. So those spaces will be prioritised for them.

I was raising the issue of toilet design within hospitals in the context of health and safety of medically vulnerable people, women and children.

Ok 👍 although his ‘third spaces’ weren’t about accessible toilets

although I get that you are drawing attention here as a seperate issue

Hopefully with trans in third spaces we can keep banked WCs etc as they were ie with gaps under and over doors. That’s how we’ve always designed them. But it’s a separate issue

It’s a linked issue. I want to keep toilets as safe as can be for everyone. I hope the en-suite toilets you mentioned would have a gap at the bottom of the door too so that there was a visual warning if the occupant was having a medical emergency.

I have been researching this topic for years, with an emphasis on the medically vulnerable. When you increase the number of private toilets, particularly with a mixed sex space in front of the cubicle, you increase the number of things that could go wrong in them and the number of opportunities for misuse. For example at least 1 rape per school day gets reported inside British schools. No one knows the actual locations of where all the assaults in schools and hospitals are, as it’s not logged, but I know perpetrators will use places that are private, soundproof that they have easy access to. Which is why ‘disabled’ toilets feature so heavily in my dataset when the location is mentioned, particularly with children. They are the ‘original’ mixed sex, private toilet.

I agree that we have always designed toilets with gaps under and over doors but this has changed a lot recently. The Department of Education guidelines only have a 5mm gap on all designs in secondary schools, including single sex ones, ‘for privacy’. When I asked about safety and risk assessments they said their department didn’t hold any. Children who are medically vulnerable are at risk and the inevitable has already happened.

I hope the Supreme Court judgement will allow safer designs to be reinstalled.

I’ve never done such a small gap and we specialise in Schools and colleges of further education. ( I’m an Architect )
Thankfully when sex is fully recognised as biological only, this nonsense of mixed spaces will be trashed and our work won’t need any revisions

The most liked posts on this thread didn’t even get a mention by @JustineMumsnet - why is that?

Mine got quite a lot of likes but not a mention but how can you tell how many likes others got.

as an aside I wonder if Wes didn’t want to answer some. ie nothing about the elderly because they plan on doing nothing

His answer about NHSE and ICB restructuring was weak.” You’ll hear from us in the next few weeks, yeah”

Good! Thank you. I am hoping the DfE Generic Design Brief and Specific School Brief will be updated soon to include safe designs in the secondary school toilet section and also not the option to have all unisex toilets. There should be no justification when on average, there will be at least a dozen pupils in an average secondary school with conditions like epilepsy, diabetes, heart conditions.

I’d be interested to know that too.

I have a feeling that the government is turning a blind eye to children with ND conditions. It is a fairly new diagnosis. I read that it wasn't until past 2000 that it was described, and is responsible for a rise in benefit payments for children and special school education, either in mainstream or special schools.

When I look at Wes Streeting it strikes me that he would easily convince himself that the children are fine and it any ND is from the families, because if he did recognise the conditions, he would have to pay out more in benefit and education.

Mothers who are affected by this should pay every attention to what he says, even to the extent of looking up Hansard and other documents online. I think like other government ministers, he would rather not discuss anything in full. That is shown by the number of resignations and sackings so far this year.

Why has there been no public consultation about the closure of the Mount Vernon urgent care unit?

@Keeptoiletssafe and @IAmNotASheep

Apologies this going down a rabbit hole…I wonder if I could ask a favour please: cld you post sources for any published data about rapes/sexual assaults in schools that take place/likely to take place in mixed sex toilets, and any other abuse of such facilities. Reason is that I am in dialogue with my local council who are renovating the original part of the local Victorian grammar (as was) school building. The high level design, which received planning approval in April, replaces separate boys and girls toilets with a single big mixed sex facility (plus lots of individual accessible toilets all over the building - this has taken a lot of space). The washbasin area in the mixed sex loo is definitely communal, and not clear from the plans but I suspect the cubicles have no gaps, though this is not specified yet on published material. Councillirs were unaware of the safety issues of this.

This school still advertises that it is a Stonewall School Champion, and one of the governors is a trans rights activist. I don’t know what his views are on toilets, but suspect I might have an uphill battle on my hands for anything that would result in segregating boys from girls. No idea about the architects’ view, would be disappointed if their design were not compliant with law but I wonder about this - to research further.
Many thanks in advance.

I’ll pm you

Single sex spaces must be provided for all schools for children over 8.
Your school cannot remove those as this is a contravention of the Eqaulities Act

Talk to building control
Check out bregs 1992 and the Equalities act.
See also the Supreme Court ruling confirmating the definition of sex as purely based on biology thus clarifying that single sex means single biological sex.

Further advice can be gained from speaking to building control at your local council in terms of clarifying the building regs requirements

Mixed sex / gender neutral spaces can be provided alongside single sex but never instead of !

Note. There is no uphill battle on this issue. Failure to comply with building regs and the Equalities Act means failure to get the work approved and potential court cases in denying students their rights. Especially as you already have single sex spaces. You cannot remove them. It is important this issue is put forward.

Your Governors do not have the power to overrule the design requirements of school facilities

( Note the design of single sex toilets allows the cubicles to have gaps for safety. )

NB
Architects personal views are irrelevant. They are there to comply with the requirements.

None of us would advice otherwise, it would be against our code of conduct and we’d get sued

Yet the Department of Education’s own guidelines allow the secondary school toilets that Bunpea is talking about. Designs like this have been signed off lots of times. Manufacturers advise schools as them being endorsed by the government.

I have had lots of correspondence with the DfE and a FOI to ask about risk assessments or equality impact assessments for their designs. The answer is their designs are for privacy and they do not hold any risk assessments or equality impact assessments in their department. They actually quoted 1974 Health and Safety legislation rather than 1992.

The photo attached comes from this document.

https://www.gov.uk/government/publications/output-specification-school-specific-brief-and-annexes

This is for England. From memory, I believe Scotland has regs from 1967 that enforced separate girls and boys toilets.

It’s a mess which I hope will be sorted out as I believe it is unlawful and discriminatory for children with medical conditions.

However, in Bunpea’s favour the DfE admitted this is their guidance and schools don’t have to use it.

There are new schools that have won awards and just had unisex toilets. The number of schools who are wondering how they are going to afford to sort out their toilets must be large: https://schoolsweek.co.uk/ehrc-guidance-causes-trans-toilet-trouble-for-schools/

Schools have been the canaries in the coal mine for all these new designs. This is a good article from Wales which sums up the problems that will happen in other unisex toilets:
https://www.walesonline.co.uk/news/education/drug-dealing-drinking-dirt-problems-28517175

I think Mr Streeting should comment on Trump's suggestion that taking panadol in pregnancy can cause autism.

I think Trump is taking too much on himself. Before US mumsa know where they are, they will be told they cannot have social security for autism because they may have bought over the counter meds without prescription!!

How long will it be before our barmy army does that?

If it affects children, perhaps it does the elderly. They are given panadol like sweets. No wonder they are confused as soon as they get into hospital or residential care.

It isn't right. It will upset a lot of parents if their culture doesn't allow it.

Bad enough phones take photos up women's skirts, on the underground etc. To give boys tanked up on hormones the opportunity to take sneaky pics won't need more than a centimetre to take photos.

The doors will have to be absolutely flush with floors, ceilings, and the next cubicle. Even then, someone will find a way.

Disgraceful.

@llizzie
Floor to ceiling cubicles might solve the privacy issue, but they are unsafe (as well as being unhygienic - see earlier in post for NHS research on unisex toilets). Toilets are where people go when feeling ill - heart attacks, epileptic fits, diabetic hypos, drug ODs, anaphalaxis (maybe carrying an epi-pen), severe asthma etc. Paramedics know this. But with floor to ceiling enclosures, no-one would know if someone was on the floor.

An example of this issue made the news in July this year when a 38 year old man, Sean Stephen, unexpectedly collapsed in such a toilet cubicle in Edinburgh council’s headquarters building. He was not found until some time after he had died, because no one could see he was on the floor, even though it had been noted he was missing and people were out looking for him.

UK data on prevalence of the kinds of health conditions which result in unexpected collapse suggests that a typical high school (of say 2000 pupils) will have several dozen pupils with conditions that result in them being at risk of collapse.

I get the point that floor to ceiling cubicles solve the privacy problem, but they are the wrong solution for schools IMHO.

Agree Keeping the issue of gaps is contentious
Privacy in mixed sex toilets is prioritised hence no gaps.

OP would need to ensure an alarm / pull cord or similar system in those along with an opening system from the outside. As it currently stands that’s the only current way to comply.

Ensuring the majority of toilets are single sex minimises risk as they, of course, can be designed with gaps.

So many reasons you can put to the Governors OP

Floor to ceiling toilets are the current design solution for mixed sex cubicles. These cubicles are only required as an addition to single sex toilets.

Singles sex banked toilets with communal whbs can be designed with gaps.
That’s the current solution

Thanks @IAmNotASheep !
yes the design shows two banks of cubicles with a communal washbasin area across the end. But no door between the washbasin area and the banks of cubicles. So nothing to stop e.g. a mischievous boy from wandering down the bank of girls’ cubicle for a lark or something worse, or I suppose a girl wandering down the bank of boys’ cubicles.

A door to each bank of cubicles would fix this and allow gaps. I can suggest this.

However my experience is that the washbasin areas need also to be single sex. Girls and women have to do things, such as clearing up after a menstrual mishap, that most of us would rather not do under the gaze of a curious boy or man. It’s about dignity. Does the Equality Act or Building Regs say anything about that?

Why not simply split the set of washbasins and put some in each of the single sex areas of the banks of cubicles? What is the benefit of having a communal washbasin area? I can’t see the point.

Alarm cords won’t work because of practicalities. Apologies that the next bit is a bit grim but the following (however rare) should be taken into account in design:

Assaults - many assaults take place in disabled toilets (space, privacy, mixed sex) and I have never read a report where the woman or child has dared to pull the alarm cord.

There’s a teacher on here that says a child used the cord to try and harm themselves - they managed to get to the child in time. This is also why you have to be careful with hook placement.

This brings me on to the next point that children would want to pull the cord. Children have died recently in new private designs in schools where I know it was due to a medical health emergency as it was published. Teachers were unaware and were unable to do cpr in time.

As an ex-teacher, I have witnessed hypos and seizures and brain injury (mini-stroke). I haven’t witnessed a child having a heart attack. In none of these medical emergencies would there be enough awareness to pull a cord. Recently spiked vapes have caused children seizures in schools - children go to the toilet to vape. Luckily so far as I know, seizures have only happened in the playground or corridors where teachers have seen immediately and done cpr.

The other reason is misuse. There is no way my Year 9’s would not have pulled those cords all the time for a laugh.

Schools have tried so many ways to alleviate problems that could be sorted with a safer, simple, cheap (no subscription) floor to door gap.
https://schoolsweek.co.uk/schools-install-toilet-sensors-that-actively-listen-to-pupils/