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An elderly man was left literally rolling around in pain outside the emergency room of Cipto Mangunkusumo General Hospital in Central Jakarta on Friday after being denied treatment.

As bystanders looked on, Sa’at, a 78-year-old from Parung Panjang in Bogor, clutched his stomach and groaned in pain. The man’s son, Matin, told the Jakarta Globe that his father had complained of acute abdominal pain since that morning.

Outside the hospital, also known as RSCM, a large sign had been put up saying the ER could no longer accept patients because its beds were full.

A catheter bag attached to Sa’at was full and nobody, aside from his son, came to his aid. Matin said the hospital, which is the biggest and considered one of the best in the country, had refused to take Sa’at in because it was overcrowded.

As Matin argued with staff at the ER, Sa’at climbed out and began rolling around on the ground in pain. “I can’t sit. It’s too painful,” he said.

Matin said he had always taken Sa’at to RSCM’s ER to change his catheter when he was in that much pain.

“We drove for hours to get here and the whole way my father couldn’t stop groaning,” he said.

“It breaks my heart to see him like this.”

A hospital security guard, who spoke to the Globe on condition of anonymity, said that was not the first time RSCM had refused to treat emergency patients.

“Aside from the lack of beds, there aren’t even any gurneys available,” the guard said, adding that the ER was almost always full. “Patients from provinces across the country are referred here. Most of the time, we are overwhelmed.

“For the past few days, doctors and nurses have had to reject patients. Those who insist on waiting are allowed to wait until a gurney becomes available. Those in a critical condition are asked to go to another hospital.”

After a heated argument with staff at the ER, Matin said he would take his father somewhere else. “We’ll have to find a hospital that will take him,” he said. “This is very disheartening.”

RSCM’s director, Akmal Taher said the hospital’s staff was not allowed to turn away emergency cases. He also said that he planned to investigate the latest incident.

“No hospital is allowed to reject an emergency patient, even if it means we have to treat them on the floor because we don’t have enough gurneys,” he said. “We have an obligation to treat genuine emergencies.”

RSCM has previously struggled to cope with large numbers of patients seeking treatment, many from poor backgrounds.

In March, two patients — one suffering from a tumor and another diagnosed with liver problems — reportedly had to endure long waits before being treated. In 2008, 26 patients at the public hospital were reportedly neglected by medical staff.

The cause of the backlog is the high number of patients referred to RSCM. Of the 2,000 patients who check in every day at the hospital, some 75 percent are from poor families. Moreover, the hospital is owed as much as Rp 24 billion ($2.8 million) from medical bills yet to be covered by the government’s health care scheme.

Kartono Muhammad, a public health expert and former chairman of the Indonesian Doctors Association (IDI), said the key to preventing overcrowding at hospitals was through strict implementation of the National Social Security System (SJSN) Law.

“Hospitals can’t dump their patients at RSCM whenever they want, and patients can’t insist to be treated at RSCM if their disease can be treated properly elsewhere,” he said.

“When the hospital is earning profit, the government puts its hand out for its share. But when it comes time for the government to pay, it stalls because there are no strict consequences.”