The Roman Catholic Church formed the bedrock of medieval European culture and held great religious and political power. In 1022 it established the College of Cardinals to elect new Popes. It used tactics like excommunication and the Inquisition to enforce doctrine and root out heresy. The Church also took on social roles like providing hospitals, schools, and aid to the poor. It held a near monopoly on salvation through controlling access to sacraments until the 16th century reforms.