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Codesign. Inclusion. Lived experience. They’re all having a moment. The intent behind each concept is to ensure that we build products and services that are fit for purpose by engaging the end users – including people with disability. So far, so good. But for some people, the lack of accessible facilities means they can’t go about the community without risking their health or safety.

Yes, this includes stairs, high counters, and heavy doors, but today, I’m talking about something more specific: toilets. Some people with disability have very high physical support needs and require ‘adult change’ bathrooms. This is different from your average accessible toilet cubicle; it is a bathroom that includes an adjustable height changing table and hoists to assist people to transfer out of their wheelchairs.

However, even in our ‘liveable cities’, adult change bathrooms are few and far between – and because of this, people with disability self-exclude themselves from everyday activities in the community. Sometimes, people will choose to go without drinking fluids all day, so they don’t need to go to the toilet. This is a dangerous and an unacceptable risk for anyone, let alone someone who has a condition that has a higher risk of infections. How is it ok for people to put themselves at serious risk of illness just to do a spot of shopping?

Adult change bathrooms are more expensive to build, so of course, few buildings have them. Today (October 2025), I searched the ‘Changing Places’ website, which allows you to find adult change facilities wherever you are in Australia, and I identified 17 adult change facilities within 2km of the Melbourne CBD. Sounds reasonable? Five are at stadiums or venues that only operate for events, one is at a hospital, and five are accessible 24/7, but are as far away as Crown Casino, Marvel Stadium and the Botanic Gardens.

Some years ago, the Victorian Government came out with great fanfare that they were supporting the Changing Places campaign and were funding adult change facilities in locations across Victoria. The five new stations soon to be opened in Melbourne are expected to have adult change facilities. It’s actually the minimum we’d expect in 2025.

If we were serious about full inclusion in community life, five adult change facilities in a city like Melbourne, which fancies itself as an arts, sport and culture mecca, is just not enough. A search within 2km of Sydney CBD shows five adult change bathrooms, only two of which are available after hours. Adelaide has six, Brisbane has two (but only at stadiums), Hobart has one and Perth three (one is under maintenance and one is at a stadium), Darwin has one and Canberra has three. How can you live your life as a full citizen if you can’t use the bathroom?

Alongside the huge impact of inaccessible bathrooms for people with disability, organisations who are trying to include people with disability in codesign and consultation also suffer. It’s a bit of a snake chasing its tail – we can’t ask people with disability what they need to access the community because they can’t access the community to tell people what they need.

Sitting behind all of this is the greater problem – real inclusion. It’s great that the Victorian Government is building more adult change facilities, but you can’t hold a meeting at a train station. If it’s prohibitive for community organisations to afford the cost of real consultation, what does it mean for people who depend on adult change facilities to live their everyday lives? If there’s a family wedding, does it have to be at Crown Casino to make sure that every family member can attend?

For my organisation, the Young People in Nursing Homes Alliance, this is a real problem. The lack of adult change toilets means that the only option for an inclusive venue is with a big fancy hotel, casino or stadium. A recent enquiry for an accessible room in Melbourne for four hours started at $2,548. We’re talking thousands of dollars for a day’s event, compared to a few hundred for an ordinary venue, such as a local library. For many community organisations, thousands of dollars for room hire isn’t something they are funded for, nor can afford. Most organisations that care about meeting the needs of the community want to do the right thing and understand and respond to everyone’s needs, but the higher costs of meeting this essential requirement aren’t funded.

Fundamentally, we’re looking at a problem where aspiration has not met implementation. The introduction of the NDIA more than ten years ago was meant to drive social and economic inclusion for people with disability, but how can this happen if you can’t even go to the dunny while you are out and about? There’s no point to NDIA funding a great plan for someone to live an ordinary life in the community if infrastructure prevents participation.

Where does this leave us? There’s a long-term and short-term fix to the problem.

1. Governments need to get real with building design requirements and make sure that adult change facilities are part of everyday builds.
2. The voices of people with disabilities must be heard, especially in designing inclusive solutions. Corporate Venues with adult change facilities should have a sliding scale that allows community organisations to use their facility at a reasonable cost.
3. The prohibited costs of codesign and consultation for people that require adult change need to be part of the funding package of grants to organisations.

The cost of inclusion should not break anyone’s heart, bank, or bladder.