Procedural Approach controllers in Australia use far more than vertical standards.
Ok, I would not want to be working Capital city trafic with procedural standards but over here in many small towers we use vertical, longitudinal[time and distance] and lateral sep standards as well as visual based sep standards.
The service is very efficient with low traffic levels.
Yes you need to have a mental "picture" of where your traffic is but it is/was the most rewarding and fun controlling that I have done.
Radar approach controllers had our procedural ratings removed years ago but yes we could provide a very limited service when the TV goes on the blink.
AA