I have worked in neurosurgery, i did it back in my house year. Juniors in surgical specialties who do a PhD (who are NOT career academics) usually do it because they're not good enough to get an NTN without one. Nobody does it post NTN just to be competitive at consultant level and nobody pre-NTN thinks that far a head as their main focus is on getting an NTN.
If you're applying for a clinical post, having a 3 year gap in your training with no solid operating will hurt you more than the "PhD" after your name will earn you. If you are a higher surgical trainee in current times then you'll know how crippling that sounds. A PhD does not make you good at clinical and operative surgery... so why would they want you for a clinical post, where service commitment is priority? Whoever's been telling you that you can't get a consultant appointment without a PhD are probably non-academics trying to justify the 3 year gap they took in their training. Funny how there are people being appointed as consultants in more competitive surgical specialties without one.
In terms of salary, your statement suggests that you know exactly how much those surgeons earn. I find it odd that the US surgeons disclosed their financial earnings to an elective student... and that the UK surgeons are very open with you about their private practice. Unless you're their accountant or you have access to their bank statements I dont think you can make a fair comparison. I suspect that what you perceive to be greater earning in the US (bigger house, fancy car) is most likely just a representation of the difference in the standard of living in the US vs UK, which is a different issue altogether.