Alex Neil, the Health Secretary, says he wants the NHS in Scotland to be a genuinely seven-days-a-week service.

It is the right ambition - the way people live and work has changed, making the idea of a nine-to-five health service unacceptable - but the important question is: how are we to achieve such a service?

The challenges are considerable. As the report into NHS Scotland by Audit Scotland demonstrated last week, the country's health boards are under massive financial pressure, meaning many of them are dealing only with short-term problems and are not properly planning for the future.

The report found, among other things, that agency staff are being increasingly used to plug holes, there is a rising number of vacancies and targets on waiting times are often not being met.

Against this backdrop, the idea of asking the health boards to provide a genuinely seven-day service, with all the staff and services a patient might need on hand every day of the week, might appear to be unrealistic but a smarter way of working could help them move towards the target.

A useful first step would be a review of capacity in hospitals - which The Herald has been calling for as part of our NHS: Time for Action campaign. Such a review would help ensure the right staff are in the right place at the right time. The review could usefully include a look at the question of whether consultants should work much more flexibly for the benefit of the system. And as Mr Neil points out, there may be other areas where improvements can be made - how and when patients are discharged, for example.

There are dangers to look out for. For example, NHS Scotland cannot move towards a seven-day care model by simply overloading staff, who are already doing their best in difficult circumstances. In looking at how care management works in the United States, the Health Secretary must also be careful to protect the NHS model of free care for all. Mr Neil has given his word that Scotland will never go down the for-profit road.

In the end, it may be that the only realistic way of moving towards seven-day care is, in part, by providing more resources but greater flexibility and different ways of working must be investigated.

The provision of care will need to expand in some areas and change in others - what it must not do is increase the strain on staff who often have unsustainable workloads.

The aim must be a better, wider, seven-day care for patients, but those who provide the care must be not be made to pay an unworkable price.