National guidance and evidence base

I've been reading this:

http://jac.oxfordjournals.org/cgi/content/full/61/5/976

Just out of interest really, as there seems to be a belief amongst certain noctors in secondary-care-land that GPs are filthy creatures who are responsible for a fair few MRSA infections.

Two main thoughts came to mind on reading the document.

Firstly, that most community acquired MRSA seems to be in people who've had recent contact with secondary care in some manner. Which is odd, as we seem to have a pelthora of posters up at the moment advising us to wash our hands at every available oppotunity so we don't kill people. I'm not aware of any evidence to suggest that GP surgeries are foci of infection, which this guidance would seem to support.

Secondly that the evidence base for this guidance is so poor. The vast majority of the recommendations throughout the document are graded as D (in other words, they are based on the opinions of the great and good rather than sound scientific data).

I can't help wondering whether HMG should be spending money on acquisition of reliable evidence for things like this rather than wasting it on white elephants (by which I mean NHS Direct, rating GPs on NHS Choices, Darzi centres and the like).