NHS European Office

How the EU works

European Commission

The activities of the European Union are taken forward by a number of bodies - the EU institutions - whose tasks and responsibilities are set out in the treaties.

The main EU institutions are:

The European Commission

The European Commission acts as the EU's executive arm and is responsible for formulating new policies, initiating legislation and the day-to-day running of the EU. It is composed of a President and 27 other Commissioners, supported by approximately 38,000 European civil servants (made up of administrative officials, policy experts, translators, interpreters and secretarial staff). The President is Ursula von der Leyen and the Commissioner for Health is Stella Kyriakides.

The Council of the European Union

Sometimes called the Council of Ministers, the Council of the European Union is the EU’s main decision-making body. The European Council, which defines the overall political direction and priorities of the EU, has a President elected by the members of the Council (i.e. the EU member countries), who serves for a term of two and a half years. The current President of the European Council is Charles Michel.

The Council also meets in other formations to discuss different policy areas. These sectoral Councils are headed by a rotating presidency, with every member state taking the helm for a period of six months. The current holder is Portugal. Meetings are attended by the relevant minister from each country’s national government, depending on the subject, and decisions are usually taken by either qualified majority (voting weighted to take account of population size) or unanimity.

Health Ministers usually meet once every 6 months as part of the Employment, Social Policy, Health and Consumer Affairs Council (often referred to by its French acronym 'EPSCO'). Each Presidency will set out a number of priority areas for their term, and the EU and health policy page provides information about Austria's health policy priorities. 

The European Parliament

The European Parliament (EP) forms the other half of the EU's legislature. Members of the European Parliament (MEPs) are directly elected every five years from all 27 member states (each country has a set number of seats based on its population size). There is no governing party in the Parliament and MEPs do not sit in national blocks but in pan-European political groups. Most EU legislation is now passed according to the 'ordinary legislative procedure' (formerly known as 'co-decision'), under which the Parliament and the Council amend and approve legislation jointly. Where the ordinary legislative procedure doesn’t apply, the Parliament still has the right to be consulted on new legislation. The Parliament also holds the other EU institutions to account, for example by asking Parliamentary Questions, and has the power to reject or censure the Commission and the EU budget.

The European Courts

The judicial branch of the EU consists of the European Court of Justice (ECJ) and the Court of First Instance (CFI). Together they interpret and apply the treaties and the law of the EU, and ensure they are applied in the same way throughout the EU. The Court of First Instance mainly deals with cases taken by individuals and companies directly before the EU's courts, and the ECJ primarily deals with cases taken by member states, the institutions and cases referred to it by the courts of member states. Judgements of the European Courts are legally binding and must be implemented throughout the EU, even if they establish rights in areas where there has previously been no EU legislation.

The EU decision-making process

The NHS European Office has produced an easy to understand tour through the complex EU decision-making process, involving the EU institutions listed above. Download the chart.

The EU and health policy page gives more information about EU activities in the area of health.

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