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Matters of convenience
124
PUBLIC
HEALTH
VOL.
LXXIX
NO.
3
MATTERS OF CONVENIENCE THE filthiness of foreigners and the nastiness of natives have for years--even for centuries--impressed themselves on the consciousness of the Englishman travelling in less favoured countries. That primitive people, especially those with dark skins, should be unhygienic is an article of faith and is taken as a matter of course. The discovery, however, that nations which pride themselves on their culture can show evidence of unsavoury behaviour is one which offers balm to tile Briton's soul and warm inflation to his ego. "They despise our British food b u t . . . " and "They call us artistic Philistines b u t . . . " come readily, almost over-eagerly, off the tongue. The French, let us face it, have been tardy in presenting to the British tourist the efficient sanitary machinery which he looks for in a hotel, and more than a few of their picturesque spots have an unkempt appearance with sundry accumulations which offend the eye and the nose. Spruce Switzerland, whose cities can look as if they are washed, dusted and even boiled every morning, has rural inhabitants who use as an unsavoury refuse dump the very spot from which the tourist would most like to contemplate a spectacuIar mountain view. Yet this is not the whole story. We would guess that French hotels and restaurants in general go one--or more than one--better than the British average in providing water, soap, and towels for the guest to wash his hands before he eats. The hotels provide the travelling Briton with that civilised amenity the bidet, which he regards as an impropriety and is as likely to misuse as to use. The Swiss, knowing that people are likely to pause and picnic at a major beauty spot, are prepared to provide the sanitary conveniences which picknickers are likely to welcome. If one compares the amenities at continental camping sites, fith those to be found in this country one finds at least one very good reason for the steady increase in the number of Britons taking camping holidays abroad. The British would seem to hold the Western European record for the promiscuous depositing of litter. On the credit side may be placed the apparent awakening of public conscience which produced anti-litter legislation, but the lack of apparent effect of that legislation suggests that it was only a part of the public conscience that was aroused. We have the impression that the litter of today has a rather higher content of food debris than that of former times, and to that extent it can be regarded as less savoury and more of an offence against hygiene. The case against litter as such, however, cannot be based on risk to the health of the people; the offence is mainly aesthetic. We mention the subject rather because of the evidence it provides of the outlook of the public at large, as evidence of a lack of concern for public amenities and for other people's comfort and convenience which is probably not unrelated to a number of aspects of public sanitation. At the Society's Annual Symposium in 1964 some strong things were said about the deplorable condition of land in the neighbourhood of lay-bys
EDITORIAL
125
on trunk roads. This criticism reflects two things, the failure of public bodies to make adequate provision of public conveniences and the lack of social understanding among private individuals. It is inevitable that travellers by road should be seized with the urges of nature while e n r o u t e and, faced with possibly another 20 miles of travel before they can find the proper place, they are naturally tempted to make use of an improper one. This is an excuse for fouling the countryside but hardly a valid reason. The next public convenience on the trunk road may be 40 minutes journey away, but well within that 40 minutes there will very probably be a convenient ',~ "-,hich can be reached by a 5-minute detour. How often, indeed, has the offender in the lay-by passed, only a short while before, through a town which would have provided what he needed if he had not been so eager to get on with his journey. Of course, he may have been travelling early in the morning or late-though not very late--at night and, had he stopped in the town, he would have found the door locked. The lack of all-night or even late-night availability of public lavatories is justified by a number of more or Iess valid reasons, including, naturally the question of cost. It is understandable that the town or district council should feel chary of spending ratepayers' money on the relief of nonratepayers who happen to be passing through, but we wonder why they should also, as so often happens, deny relief to those of their ratepayers who have been to the theatre or the cinema and have, perhaps, had a late snack afterwards. So far as the quality of public provision is concerned, there have been recent substantial improvements. Conveniences are usually well, and in general tolerably, looked after by the local authority, so far as cleanliness is concerned. But those which, are not served by a permanent attendant are likely to be shabby, dilapidated and uncomfortable, the result of vandalism by local hooligans which seems to be on the increase and difficult to control. It is said, and with some truth, that hand-washing provision is usually the first and the most vulnerable target for the vandals, but this is not a universal finding. The travelling connoisseur will probably know of a few unattended places which would shame, in this respect, the facilities of some attended ones. Is it possible that there are towns which have used past vandalism or the mere fear of vandalism as an excuse for not spending money on washing provision ? A free hand wash, or at least a rinse, is now provided in the great majority of such local authority conveniences as have attendants. It therefore seems reasonable to ask why railway stations lag so far behind in this respect. Even where there is no regular attendant, the conveniences are on enclosed premises where supervision is easy and where the risk of vandalism is minimal. British Railways are at least candid in their explanation; their official spokesman has said that the reason is financial, pointing out, somewhat ingenuousl3,, that local authorities can afford it because the public pay, through the rates, for these amenities. We would have thought it reasonable to reply that the local authorities are prepared to pay out of the ratepayers' money without asking
126
PUBLIC
HEALTH
VOL.
LXXIX
NO.
3
that the washing of hands should be restricted to ratepayers, whereas railway station conveniences are accessible only to people who have specifically paid sums to the railway authority either for their travelling ticket or, at least, for a platform ticket. From the public health point of view, however, the most important need for good sanitary accommodation and washing provision arises in places where food and drink are consumed; the precautions taken in respect of the staff may be brought to nothing if there is inadequate provision for the customers. The more expensive hotels and restaurants usually provide what is necessary, but the smaller cafes and restaurants tend to cut down to an irreducible minimum if, indeed, they provide anything at all. Maximum squalor is most likely to be found in public-houses. This may have mattered comparatively little in the days when drinking was the sole business of the establishment, but now that more and more pubs are providing snacks and even meals the possible risks are increasing. The need is important and the excuse for not meeting it is flimsy in the extreme. All these places are enclosed and supervised and the customer pays for food, drink and service. The owner of the small care may not have much money to burn, but the majority of public houses are owned by anything but poverty-stricken brewery companies, and it is simply not good enough that their sanitary shortcomings should have to wait their turn in a long-term modernisation programme. Taken all round, the British certainly have little to boast of in their provision of public sanitation. In general, we have no love for "pressure groups", but where the cause of a deficiency is due to a combination of public apathy and vested interests the pressure group can well be the best instrument for preparing the way for effective action. The six-months-old Advisory Council on Public Sanitation has certainly shown signs of vigour in its infancy, and even though it may not feel impelled to enter all the parts of the field we have defined, the aims recently expressed by its chairman. "We are resolved to draw the attention of H.M. Government, of local authorities and of the public in general, to the need for a dramatic improvement in the number and in the cleanliness of our public lavatories", would seem to be a good start. The public health service will certainly welcome any progress on these lines.
PUBLIC
HEALTH
VOL.
LXXIX
NO.
3
MATTERS OF CONVENIENCE THE filthiness of foreigners and the nastiness of natives have for years--even for centuries--impressed themselves on the consciousness of the Englishman travelling in less favoured countries. That primitive people, especially those with dark skins, should be unhygienic is an article of faith and is taken as a matter of course. The discovery, however, that nations which pride themselves on their culture can show evidence of unsavoury behaviour is one which offers balm to tile Briton's soul and warm inflation to his ego. "They despise our British food b u t . . . " and "They call us artistic Philistines b u t . . . " come readily, almost over-eagerly, off the tongue. The French, let us face it, have been tardy in presenting to the British tourist the efficient sanitary machinery which he looks for in a hotel, and more than a few of their picturesque spots have an unkempt appearance with sundry accumulations which offend the eye and the nose. Spruce Switzerland, whose cities can look as if they are washed, dusted and even boiled every morning, has rural inhabitants who use as an unsavoury refuse dump the very spot from which the tourist would most like to contemplate a spectacuIar mountain view. Yet this is not the whole story. We would guess that French hotels and restaurants in general go one--or more than one--better than the British average in providing water, soap, and towels for the guest to wash his hands before he eats. The hotels provide the travelling Briton with that civilised amenity the bidet, which he regards as an impropriety and is as likely to misuse as to use. The Swiss, knowing that people are likely to pause and picnic at a major beauty spot, are prepared to provide the sanitary conveniences which picknickers are likely to welcome. If one compares the amenities at continental camping sites, fith those to be found in this country one finds at least one very good reason for the steady increase in the number of Britons taking camping holidays abroad. The British would seem to hold the Western European record for the promiscuous depositing of litter. On the credit side may be placed the apparent awakening of public conscience which produced anti-litter legislation, but the lack of apparent effect of that legislation suggests that it was only a part of the public conscience that was aroused. We have the impression that the litter of today has a rather higher content of food debris than that of former times, and to that extent it can be regarded as less savoury and more of an offence against hygiene. The case against litter as such, however, cannot be based on risk to the health of the people; the offence is mainly aesthetic. We mention the subject rather because of the evidence it provides of the outlook of the public at large, as evidence of a lack of concern for public amenities and for other people's comfort and convenience which is probably not unrelated to a number of aspects of public sanitation. At the Society's Annual Symposium in 1964 some strong things were said about the deplorable condition of land in the neighbourhood of lay-bys
EDITORIAL
125
on trunk roads. This criticism reflects two things, the failure of public bodies to make adequate provision of public conveniences and the lack of social understanding among private individuals. It is inevitable that travellers by road should be seized with the urges of nature while e n r o u t e and, faced with possibly another 20 miles of travel before they can find the proper place, they are naturally tempted to make use of an improper one. This is an excuse for fouling the countryside but hardly a valid reason. The next public convenience on the trunk road may be 40 minutes journey away, but well within that 40 minutes there will very probably be a convenient ',~ "-,hich can be reached by a 5-minute detour. How often, indeed, has the offender in the lay-by passed, only a short while before, through a town which would have provided what he needed if he had not been so eager to get on with his journey. Of course, he may have been travelling early in the morning or late-though not very late--at night and, had he stopped in the town, he would have found the door locked. The lack of all-night or even late-night availability of public lavatories is justified by a number of more or Iess valid reasons, including, naturally the question of cost. It is understandable that the town or district council should feel chary of spending ratepayers' money on the relief of nonratepayers who happen to be passing through, but we wonder why they should also, as so often happens, deny relief to those of their ratepayers who have been to the theatre or the cinema and have, perhaps, had a late snack afterwards. So far as the quality of public provision is concerned, there have been recent substantial improvements. Conveniences are usually well, and in general tolerably, looked after by the local authority, so far as cleanliness is concerned. But those which, are not served by a permanent attendant are likely to be shabby, dilapidated and uncomfortable, the result of vandalism by local hooligans which seems to be on the increase and difficult to control. It is said, and with some truth, that hand-washing provision is usually the first and the most vulnerable target for the vandals, but this is not a universal finding. The travelling connoisseur will probably know of a few unattended places which would shame, in this respect, the facilities of some attended ones. Is it possible that there are towns which have used past vandalism or the mere fear of vandalism as an excuse for not spending money on washing provision ? A free hand wash, or at least a rinse, is now provided in the great majority of such local authority conveniences as have attendants. It therefore seems reasonable to ask why railway stations lag so far behind in this respect. Even where there is no regular attendant, the conveniences are on enclosed premises where supervision is easy and where the risk of vandalism is minimal. British Railways are at least candid in their explanation; their official spokesman has said that the reason is financial, pointing out, somewhat ingenuousl3,, that local authorities can afford it because the public pay, through the rates, for these amenities. We would have thought it reasonable to reply that the local authorities are prepared to pay out of the ratepayers' money without asking
126
PUBLIC
HEALTH
VOL.
LXXIX
NO.
3
that the washing of hands should be restricted to ratepayers, whereas railway station conveniences are accessible only to people who have specifically paid sums to the railway authority either for their travelling ticket or, at least, for a platform ticket. From the public health point of view, however, the most important need for good sanitary accommodation and washing provision arises in places where food and drink are consumed; the precautions taken in respect of the staff may be brought to nothing if there is inadequate provision for the customers. The more expensive hotels and restaurants usually provide what is necessary, but the smaller cafes and restaurants tend to cut down to an irreducible minimum if, indeed, they provide anything at all. Maximum squalor is most likely to be found in public-houses. This may have mattered comparatively little in the days when drinking was the sole business of the establishment, but now that more and more pubs are providing snacks and even meals the possible risks are increasing. The need is important and the excuse for not meeting it is flimsy in the extreme. All these places are enclosed and supervised and the customer pays for food, drink and service. The owner of the small care may not have much money to burn, but the majority of public houses are owned by anything but poverty-stricken brewery companies, and it is simply not good enough that their sanitary shortcomings should have to wait their turn in a long-term modernisation programme. Taken all round, the British certainly have little to boast of in their provision of public sanitation. In general, we have no love for "pressure groups", but where the cause of a deficiency is due to a combination of public apathy and vested interests the pressure group can well be the best instrument for preparing the way for effective action. The six-months-old Advisory Council on Public Sanitation has certainly shown signs of vigour in its infancy, and even though it may not feel impelled to enter all the parts of the field we have defined, the aims recently expressed by its chairman. "We are resolved to draw the attention of H.M. Government, of local authorities and of the public in general, to the need for a dramatic improvement in the number and in the cleanliness of our public lavatories", would seem to be a good start. The public health service will certainly welcome any progress on these lines.