Karin Joesbury wipes away tears when asked whether the 1,448-page report into Vancouver's missing women case could make a difference in the future for vulnerable women like her daughter Andrea.

"I hoped it would change things. I hope that it does, I really do," said Joesbury, whose daughter is one of the six women Port Coquitlam serial killer Robert (Willy) Pickton has been convicted of murdering. "But I feel like we spent a lot of money, maybe wasted money."

The report released Monday comes more than two years after an $8million inquiry was struck to examine the missing women case, and more than a decade since Pickton's arrest.

Former attorney general Wally Oppal, head of the inquiry, put 65 recommendations in his voluminous report, many of them calls for changes that have been discussed publicly over the years.

Oppal hopes that listing the recommendations together in the hefty document will prompt policymakers to act.

He also believes the climate is right in B.C. to make some of the changes, such as bringing in regionalized policing and improving the treatment of vulnerable women.

Oppal, a former B.C. Appeal Court justice, said his review of the investigation evidence led him to the conclusion "that there was systemic bias by the police in the missing women investigation."

"They did not receive equal treatment from police. As a group they were dismissed."

Some relatives of the missing women, who felt ignored by police, let down by the justice system, and left out of Oppal's inquiry, aren't convinced vulnerable women will be safer as a result of the report. The inquiry heard from 85 witnesses over 93 days and collected 150,000 pages of evidence, as it examined why it took so long for the Vancouver police and RCMP to identify Pickton as a serial killer, despite warnings he was preying on sex workers in Vancouver's Downtown Eastside.

The provincial government has already addressed several of Oppal's wide-ranging recommendations, including appointing former lieutenant-governor Steven Point as a "champion" to implement the findings. But Point faces a significant task, as some of the recommendations have been discussed without being acted on for years. These include regionalized policing and bus service along B.C.'s isolated Highway 16, where many women have disappeared.

Others, such as increased sensitivity training and changes in how missing person cases are investigated, will require buy-in from police,

Still others will cost money, such as a 24hour drop-in centre in the Downtown Eastside and a compensation fund for the children of the missing women. That recommendation appealed to Cynthia Cardinal, whose sister Georgina Papin was one of Pickton's victims.

"Georgina's kids - she's got seven of them - they don't have any support, except from us," said Cardinal, who was devastated by the police response in her sister's case, and isn't confident things will change.

Oppal wrote the VPD had an obligation to warn women in the Downtown Eastside about the danger they were in, "and utterly failed to do so."

The police investigations were also "wholly inadequate" when following up tips, "plagued by unacceptable delays" and failed to properly use techniques such as surveillance, undercover operations, search warrants and forensic evidence, the report said.

It concluded the VPD showed a lack of urgency in responding to the mounting numbers of missing women, partly because police failed to "get to know" the victims and believed inaccurate information, such as that they would "turn up" one day.

Since Clifford Olson's killing spree decades ago, there have been multiple calls for a regional force in the Lower Mainland, which is policed by a patchwork quilt of municipal agencies and RCMP detachments. Pickton's victims disappeared from the VPD's territory, but he did his killing at his home in Port Coquitlam, which is policed by the RCMP.

Oppal's report said there was a "general systemic failure" by the two agencies to deal with those cross-jurisdictional issues. This fragmentation of policing led to "serious communications failures," a breakdown in evidence sharing, and a lack of funding because of the low priority given to the case, the report said.

As well, he said, the case lacked any leadership by any police agency. "No senior management at the VPD, RCMP E Division Major Crime Section, Coquitlam RCMP, or Provincial Unsolved Homicide Unit took on this leadership role and asserted ongoing responsibility for the case."

There was a "wholly unacceptable delay," Oppal added, in finally forming a joint-forces task force in 2001; by then an estimated 60 women had disappeared from the Downtown Eastside over about 20 years.

Deputy RCMP Commissioner Craig Callens said in a statement that he welcomed Oppal's report, but would need time to review the recommendations.

Vancouver police would not comment Monday.

Oppal said not all the mistakes in the case belong to police, noting there were other systemic issues that led to the victims ending up on the street, including poverty, racism, drug addiction and a lack of affordable housing.

"Even though Pickton is in jail, the violence against women in the Downtown Eastside and other areas of this province continues. It is time to stop the violence," Oppal said.