some would prefer to scrape in at 200' every time, rather than fly an ILS.
HC, not every airfield is Aberdeen - or has an ILS. Of those that do some have higher minimums than 200'. I have landed at many hospitals but not one has an ILS approach. Any competent IR rated pilot can safely fly an ILS solo or monitor the helicopter doing so.
SAR operations often involve letting down to a vessel or cliffs in the pitch dark using auto-pilot SAR modes, search radar, FLIR and NVG as a combined 4 crew operation. Once the SAR Op is complete we still have to return to base or the hospital and, if the weather is below 'normal' limits, this will also involve a pre-determined and practiced Poor Visibility Approach again using SAR modes, search radar, FLIR and NVG.
We all maintain IFR approach currency but SAR night/low-vis approaches are much more difficult and carry higher risk. Therefore these are practiced more often and hence SAR crews who operate in the low-level environment prefer to practice in this environment, or, as you put it 'wazz around at 200 feet'