I am in the UK and use it.
Its a great service.
The reason I used it is because it allows you to set up Direct Debit for clients, and it makes it really easy - just add a "service" add clients details and it will send them a setup form via email.
They fill it in, send it off (again via email reply) and thats it done.
For me, I found paypal subscriptions much harder.
I also use Stripe for one off credit debit card payments, again its very easy, easy to integrate into website and so on.