I agree. Many pilots think that with the Takeoff analysis tables (or runway tables) you got the RTOW and you are ok for every problem....
The SID gradient is based on All engines operating and it's not related to the RTOW given in the Takeoff Analysis (except if the Dispatch Program used gives the facility to obtain the RTOW for the SID as said by Old Smokey).
The fact is that almost in each area we have the Radar control and the MVA that usually are lower than the MSA. But, even if I live in Italy, my city airport, Alghero Fertilia LIEA in Sardinia island has still the Procedural Approach (with the help of Rome ACC that covers with Radar till about FL100)...
Regards
Davide