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. 2002 Apr 27;324(7344):1027–1030. doi: 10.1136/bmj.324.7344.1027

Box 3.

The institutional triangle

The European Commission—The commission is a permanent civil service of some 17 000 officials headed by a team of 20 politicians (commissioners), one commissioner from each of the 15 member states plus a second from the five biggest member states. The commissioners are appointed for five years and their appointment is subject to confirmation hearings in the European Parliament. The commission's role is to initiate EU policy, act in the general interest of the EU (as opposed to individual member states), and ensure that, once agreed, EU laws and policies are implemented. Each commissioner has responsibility for a particular policy area. The commissioner responsible for health policy is David Byrne, who was attorney general in the Irish government before his appointment.
The European Parliament—The parliament has 626 members (MEPs) who are directly elected by EU citizens once every five years. MEPs are members of national political parties: member states are allocated seats in the parliament in accordance with their size, but they sit in pan-European political groupings. As a general rule, all EU laws and all spending decisions require the approval of—and may be amended by—the parliament.
The Council of Ministers—The council represents the governments of the member states. It meets in different permutations according to the business in hand. Thus the regular meeting of agriculture ministers is the agriculture council, that of environment ministers the environment council and, once every six months, that of health ministers the health council. The council's approval is required for all major decisions in the EU. However, on those law making and budgetary issues where parliament's approval is also needed the final decision must be negotiated between the two institutions. On most issues the council decides by qualified majority voting, a system that means that at least 11 of the 15 member states need to support a decision.