Yes, monkeypatching is very useful!
Somehow, names seem to be highly influencial on people's perception. Call it "monkeypatch" and it sounds bad, call it "hot fix" or "on-the-fly fix" and it sounds good.
Independently of that, I think the capability to alter methods/attributes/functions at runtime is a very useful thing. Even javascript people use it all day long without perhaps knowing it.
For instance:
button.onclick = function(e) { ...}
This simple line illustrates the fact that you alter the behavior of button. It was designed that way. Likewise, you could alter every other function but it would be silly to do so.
Now, for the question of delivering patches that way... well... why not. You just have to download a small patch instead of a big release. Heck, you could even patch a server without stopping it, great! And then, one day, you could also fetch the latest release for a bigger update. Fair enough. So yes, I vote for "runtime patches" as a good thing.
Interestingly enough, some languages like Erlang were even build around this concept. The capability to update a server on the fly.
Of course, in the end, and like with everything else, it's a matter of how you use it. You can make wonderful OO stuff and shitty one, it's all the same.
EDIT:
Let me add some case distinction, whether you are patching your own library or a third-party one.
...basically, what you do with such a patch is fixing a bug of your own or a third party library. In either case it's useful. For your own, it enables you to deliver a fix on-the-fly. For a third-party one, either you wait (several months?) until they fix it by themselves, or you do it now on your own. (you can still submit them the patch, so that they will fix it on their side). When they release their next lib version with the issue fixed, you can still, if you want update the library and remove the patch on your side.
Now, of course, if you use a patch to alter the behavior of a lib and alienate its purpose/way of working, then obviously that's a recipe for disaster. Even a monkey would see that ...well, I hope. ;)