Folks,
What it ultimately boils down to (IMHO)is the regulators and the influences on them. In the states any changes in regs have to be justified to all lobbies. And in terms of safety you need to have the balls to stand up and make the rules even when you cant statisically justify them to the nth degree.
Eg.....There is ATC at small fields all accross the U.S. and none in Fourchon. Why... no one will pay for it. Crazy I say... there are a bozillion aircraft operating from there. You shouldnt need ten mid airs to see the logic that it is required.
The FAA refuses to put in place sensible regs for EMS either.
The helicopter companies are always under pressure from the small start ups and until the FAA makes it harder for those guys and their standards the situ will continue. Fullstop.
And the north sea shouldnt get too smug either. In the GOM under IFR in IMC you need a full IFR clearance for a non radar environment all the way to the deck. The seperation required really slows things down. This is not the case in the north sea.