This is a very interesting question and is obviously not something that can be laid directly at the door of the airlines. The CAA/FAA and other regulatory bodies must have approved the aircraft layouts and I assume that they are pretty much standard for all airlines.
I must admit that I have often wondered why the toilets are so small but quite what one does about this is far from obvious.

I agree, the toilets should be bigger. Why can't we start a campaign to influence the airlines to configure their next aircraft better?

Following Mr Keat's letter, I decided to do some investigations and am astounded at how we (by which I mean able-bodied people) seem to have managed to ignore this issue.
Clearly, the airlines do not want to sacrifice revenue earning seats to make room for larger toilets and the floor space that would be necessary for proper wheelchair access. They respond to regulations and not empathy with their customers.
Sadly, the regulatory initiative is somewhat slow coming. In 2003 the Access to Air Travel for Disabled People - Code of Practice was published by the US DoT stating that " all wide bodied aircraft (and some single aisle aircraft) should be equipped with at least one spacious lavatory catering for disabled people with a range of disabilities". I can find little evidence of that code of practice having been implemented.
The one beacon of hope appears to be Singapore Airlines which does seem to have listened to its customers and provided highly rated disabled facilities. So, if one can do it then they all can - and clearly should.

It is nice to see this topic being discussed (at last). I have been a wheelie for four years following a road accident. I used to be part of the human race, travelling by air and doing normal things. Now, I am very aware of 'access issues' that unnecessarily limit my freedom.
For the nitty gritty, not being able to walk means that I cannot use the onboard toilets. I catheterise but am still able to empty my bladder myself and, whilst some airlines offer an aisle transfer seat, this is not that common. Restricting my fluid intake is ok for a few hours but not viable for trans-Atlantic flights.
Many readers will say 'too much detail' but this does need an open discussion if anything is to be achieved.

I feel sorry for disabled people using air travel but until we get bigger aircraft there really is not much that can be done to help them. Under the current arrangement, there is just no room for wheelchairs and disabled toilet access.

I sympathise with the disabled. I too have seen a disabled lady being manhandled into a toilet that was impossibly small for her. With all the disability ramps and access that we now have to have in offices and public buildings, the airline situation really is a bit of a disgrace.

I've never really had a problem with the size of aircraft toilets, but it must be hugely problematic for disabled and oversized people. I hope for bigger and better designed aircraft in the future.

What a wonderful observation let us hope that the airlines will take this on board

Yes, there are a huge amount of disabled people in the UK alone, around 10 million. It does surprise me that airlines have overlooked them with the tiny inaccessible toilets in their aircrafts.

How have the airlines gotten away with this for so long? I was a part-time governor at a college of FE and we had to spend £11,000 a couple of years ago to re-construct an entrance for disabled use (despite there being other disabled access). If the rules apply (very strictly) for public places like colleges, I cannot see how the airlines can be so far out of step.

Apparently some airlines are redesigning aircraft interiors to provide toilets that are wheelchair accessible. DPTAC is currently working with the aviation industry to develop accessible toilet designs.

If economy airlines (Ryanair) are going to start charging for plane toilets they better make damn sure that they are more accessible for disabled travellers.

Yes, this is a bone of contention with me. We once flew to Palma from UK but had to watch fluid intake and rush to the airport loo when we landed. I did read that the plan is to build larger toilets in planes to accommodate a wheelchair.Hopefully this is not in the far-distant future.

I think that there is to much room on certain aircrafts for things that are not needed. For instance the 'food preparation' area is completey pointless as all the food is bought in on to the aircraft! Why not make the certain area smaller and expand the toilet area so that it will suit the needs of all passengers?

The airlines cannot change the structural design of the aircraft. All they can do is listen to the complaints from passengers and feed this into the design request for new aircraft.
At best, it will take five years but it starts with comments and columns like this.

Hey everyone, earlier this year I travelled on virgin atlantic from london to las vegas, I think it was about a 12 hour flight there, something like that, and about 10 hours back. I am a wheelchair user and cannot stand at all. I was told I could use the toilet on plane but I never did, I just drunk as little as possible and ate as little as possible while on the plane. It was a nightmare.
Worst thing is I love las vegas now, and I'm going back with my wife next year, i just wish someone would sort out the plane toilets properly. Disabled people should be able to use the toilet on a plane without being made to feel awkward or uncomfortable. I would even pay extra for my plane ticket if it meant I were able to just take a piss on the plane... It's the most basic of human needs, why should the disabled be denied it without being made to feel like a nuisance?

The lack of washroom space on normal aircrafts is abysmal. I have a disabled relative and she dreads flying long haul because of the poor toilet facilities. Obviously it is a major issue for passengers with special needs but also for families travelling with small children.

I had the misfortune to twist an ankle in Havana and hobbled off to the loo on Virgin on the way back. I was grateful that there were handles to grip in there but I was also grateful that I did not have a pair of crutches to maneouvre. I think it would have had to be me or the crutches in the loo! On my flight there were 3 or 4 "wheelchair" cases (ie we needed airport assistance), with one lady having to be wheeled to her seat. Surely there could be one bigger loo on each plane say between Premier Economy and Business Class for use by anyone on the plane with a disability and available for the Business/PE passengers as well? There should also be a wheelchair which can go down the aisles actually on the aircraft surely, to help those who cannot walk/hobble to the loo?

Further to the above, apparently I slept through the wheelchair bound lady being wheeled mid-flight to a loo at the front (ie "forward of THE curtain") by her husband. So on Virgin at least, there are narrow wheelchairs on board and a more roomy loo towards the front. The moral is "ask" and you may be surprised.

I have taken my son (age 20), who is wheelchair bound, on holidays on my own, & have told him he can't drink 2 hours before the flight, because of this situation (can't lift him as I am 9st & 5'3").
The narrow wheelchairs used on aircraft (many ailines have these) are not suitable for all users as severely disabled/ill people need their own chair, as they have balance/ support issues.
I would gladly pay an increased fare for him to have a suitable toilet facility - that is a toilet having space to accommodate a wheelchair & grab rails to assist with transfer problems. This would facilitate a flight duration longer than 2 hours.

I salute Mr William Keat, who first raised this serious drawback in the passenger aircraft of all the International Airlines, over a year ago on 12 May 2010.
The responses from a number of sensitive observers as well as the kins of the affected disabled persons are eloquent enough to emphasise how essential it is for the Airlines to provide wheelchair accessible toilets on board aircraft on long distance flights like the Trans- Atlantic flights.
Mr Jasper Kelly states , "In 2003 the Access to Air Travel for Disabled People - Code of Practice was published by the US DoT stating that ' all wide bodied aircraft (and some single aisle aircraft) should be equipped with at least one spacious lavatory catering for disabled people with a range of disabilities".
He has lamented that the code practice is yet to be implemented. The regulators or the Airlines have apparently decided to ignore this issue for narrow, selfish, commercial reasons.Will someone advise how to unite and shake them up?

My response from Virgin Atlantic when I enquired about an accessible onboard toilet:-
Thank you for your enquiry.

The type of aircraft used on this route does not have a larger disabled toilet only the standard toilets.
I assume from your message that your husband will not be catheterised for the flight.
You are no doubt aware that our crew cannot assist with any lifting/transfers but can certainly make the onboard wheelchair available during the flight. They can certainly block off the centre toilet block in economy to give some privacy but could not assist in any other way.
There are appliances that can be obtained that are designed that a person with no/minimal mobility could urinate in to a container that would not be spillable. Details can be found on the internet and one site that I found is www.whennaturecalls.com or just enter Portable Urine Pouches.

My mum suffers from parkinsons & early stage dementia. Well done Manchester airport for all your help in making check in and boarding problem free. But what next?, trying to use a toilet on board when you have a disability is so stressful for both the disabled person & carer/partner. The stress caused can ruin a holiday before it even starts (Mum has been worried for days). All other forms of transport seem to respect disability so why not air travel. It's about time the air authorities got together and sorted the problem out. Let's remember people are living longer and therefore there is an increasing number of elderly people traveling with or without a disability and the tiny space provided is just not big enough. Also an increase in the size of hand washing sinks/tiny holes in the wall would provide better all round hygiene. My Mum is a lovely lady and she should be allowed to travel with dignity.

read most comments with interest.
Problems do not arise by being disabled I am 6ft 2in tall and cannot stand upright to pee in these toilets because of the curvature of the planes body, stood upright i am a good 12inches away from the bowl.The toilets should be built in the cente of planes facilitating height and space.

tiolet facilities must be made accessable for disabled passengers including grab rails etc for flights exeding 4 hours. it is discrimination against disabled peoplenot to do this it is time you draged your selves in to the 21st century and addressed this very important issue.

My mother is a double amputee and confined to a wheelchair. Both my mother and father enjoy travelling and have had several holidays abroad but they stick mainly to cruises and holidaying in the UK for this very reason. My mother would LOVE to go to New York this year to celebrate their 40th wedding anniversary and the only thing holding them back is that my mother is so worried that there is no wheelchair access to the toilets onboard the planes and she could not "hold it" for 10hrs!! It amases me in the year 2012 we are not accomodating travellers from all walks of life including meeting the needs of all disabled travellers. It's simply not good enough!

Interesting reading all the comments about aircraft toilets. I am a wheelchair user who like one of the previous people who has commented cannot walk or stand at all. I think advice about catheterisation is appalling. Why should we have to do this to our bodies just because the designers can't get the toilet the right size. I regularly fly long haul and do use the on board wheelchair. It is a struggle to transfer on to the loo, but what is worst is the high wash basin -for someone who can't stand up they are dreadful. Come on designer please get your act together

Iam the mother of a 13 year old daughter, with severe quadriplegic cerebral palsy. We desperatly want to fly long hall with our family, the thought of having to compromise our daughters dignity is appalling, our daughter need our full support for all her needs, yes just like a baby, except she's a young woman. l have experienced a short 2hr flight to Paris which had me in tears. will we ever be brave enough to try flying again? l would be most grateful for any advice. These delicate topics often offend some people, but its a basic human function.... need, that we all should be able to perform in a dignified way. We certainly should not have to pay extra for, nor be discriminated against, made suffer by drinking less or eating less on a 10 hr flight across the world to see your only granddaughter. it saddens me that in this marvellous world of technology and culture we live in. is it only the able bodied that have the god dam rite to access it. LETS FLY AWAY

I have an 18 year old son with Cerebral Palsy and have only managed flights with max time 4 hrs. Each airline has varied in its care of him. The best airport was the tiny airport in Kerry, Ireland!!! The worst.....Luton and Stansted!!
I have friend in Australia and just don't see how it would be possible to fly for so long without using the loo!
I think it's disgraceful that we can send men to the moon but NOT someone in wheelchair to Australia with a decent sized Loo!!!

Karen, et al:

We fly with our 16 year old daughter long-haul from Australia to Europe, the US reasonably often. She has paraplegia. It CAN be done.

Any airline we've ever flown has been able to provide an aisle wheelchair. A Flight Attendant will help push it to the toilet, and then screen off the toilet for privacy (using the loo dictates having the door open).

It's a right pain, but it can be done. But every disability brings with it it's own challenges, so I can't say that your son might be able to manage.

Next trip, we're going to experiment with using a catheter in-seat.

FYI, Qantas on their A380 had a great big bathroom which was perfect for disabled use. They're currently in the process of replacing it with more seats. Damn shame, and as others have said, they just wouldn't get away with that kind of attitude on the ground.

I suffer terribly with claustrophobia and have used toilets on plane but feel very panicky in them and on an 8hr flight from Miami to Heathrow, I simply could not use toilet for fear of small enclosed space. I know many others who feel the same and if toilets were bigger, it would satisfy many more able bodied customers too. It must be awful for the disabled!

I had to race to toilet once off flight. My having a bed on flight helped as I was desperate for the toilet but found I had to sleep to help stop thinking about needing the loo! Other than that, the luxury of upper class helped ease the problem.

Great comments. My wife has MS and has difficulty walking , balancing and bladder control problem too. She uses a walker.We fly long distance across pacific often spending 12 to 15 hours on a non stop flight. I made travel plans by Malaysian Airlines to travel to Kuala Lumpur and beyond in the last week of this month. When I requested the travel agent for seats in the front and close to the toilet he said the airline will accomodate my request at the time of check in. I did request 'handicap' assistance when I booked the tickets. I contacted the airline office in Los Angeles and made requested seat allocation. We were given seats in row 37 which is at the very end of the aircraft saying that is where we can get seated together and also close to toilet (near row 41). When asked whether they will provide on board wheel chair, I was told they do not. This is from one of the 'good' airlines. It is a shame the disabled can not travel with minimum comfort even in this century.