More than £10 million has been cut from spending on public conveniences in the past two years, posing a risk to public health, according to a new study.
Research by Unison found that councils across England are spending 13% less on maintaining and repairing conveniences compared with the 2010/11 financial year.
Some councils have slashed more than £250,000 from their budgets, with the biggest cuts in London and the North West.
Heather Wakefield, national officer of Unison, said: "We have come a long way from the Victorian sewer-streets, awash with human waste. It should be the measure of civilised society whether people can go to the toilet when they need to, without having to pay.
"As our investigation has uncovered, the scope to do so is being cut in many councils.
"This is not just about revellers, and those who have had too much Christmas spirit, there's a serious public health concern that needs to be addressed. For thousands of people suffering from long-term or chronic illness, waiting until you get home is simply not an option.
"Relying on the goodwill of cafes, pubs and restaurants is simply not good enough - particularly when 'customers only' is a regular policy for businesses.
"Environmental health cuts are posing a significant risk to the public's health. Savings need to be made, but they must not be made at the cost of people's health, public sanitation and basic human need."