I hate to say it but some of the dirtiest loos I've seen in this country have been in my local hospital, including on the wards.
I have OCD tendencies so for years now in public toilets after relieving myself I have "scrubbed up" like a theatre nurse at the washbasins, turned the tap off with my elbow and exit with a tissue on the door handle.. I never touch loo handles themselves without a tissue. I used to pull the chain with my foot until I lost a flip flop down the pan at Wimbledon tennis!!
Xxx